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NPI Code Detail

MEDICARE: DR. WILLIAM BRUCE ELLIS M.D.

MEDICARE: DR. WILLIAM BRUCE ELLIS 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
1207P00000XEmergency Medicine Physician3763MT

General Provider Information

NPI Number : 1821025792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM BRUCE ELLIS M.D.
Provider Business Mailing Address
First Line : 401 S ALABAMA STREET
Second Line :
City : BUTTE
State : MT
Zip : 59701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 S CLARK ST
Second Line :
City : BUTTE
State : MT
Zip : 59701-2328
Country : US
Telephone Number : 406-723-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/08/2007

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