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NPI Code Detail

MEDICARE: DR. ANDREW B GENTRY M.D.

MEDICARE: DR. ANDREW B GENTRY 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
1207R00000XInternal Medicine Physician0101233776VA
2207RG0100XGastroenterology PhysicianMED-PHYS-LIC-26717MT

General Provider Information

NPI Number : 1922072560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW B GENTRY M.D.
Provider Business Mailing Address
First Line : 915 HIGHLAND BLVD
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-6902
Country : US
Telephone Number : 406-414-5336
Fax Number : 406-414-5553
Provider Business Practice Location Address
First Line : 875 S COTTONWOOD RD STE 200
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-4222
Country : US
Telephone Number : 406-414-5336
Fax Number : 406-414-5337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 04/10/2025

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