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NPI Code Detail

MEDICARE: JEFFREY R BALISON M.D.

MEDICARE: JEFFREY R BALISON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician10293MT

General Provider Information

NPI Number : 1225138845
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY R BALISON M.D.
Provider Business Mailing Address
First Line : 2421 APPLEWOOD AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-2856
Country : US
Telephone Number : 406-656-6159
Fax Number : 406-656-6159
Provider Business Practice Location Address
First Line : 2345 KING AVE W
Second Line :
City : BILLINGS
State : MT
Zip : 59102-6422
Country : US
Telephone Number : 406-651-5670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 07/08/2007

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