Provider Demographics
NPI:1003922014
Name:WILLIAMS, JEANNE H (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KRUGER RD
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-9506
Mailing Address - Country:US
Mailing Address - Phone:406-826-4816
Mailing Address - Fax:406-826-4898
Practice Address - Street 1:10 KRUGER RD
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859-9506
Practice Address - Country:US
Practice Address - Phone:406-826-4816
Practice Address - Fax:406-826-4898
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10845207P00000X, 207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTPENDINGOtherBLUE CROSS/MONTANA
MTPENDINGMedicaid
MTPENDINGMedicaid
MTH16430Medicare UPIN