Provider Demographics
NPI:1033709225
Name:KALISPELL REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:KALISPELL REGIONAL MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-1724
Mailing Address - Street 1:60 FOUR MILE DR STE 10
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2663
Mailing Address - Country:US
Mailing Address - Phone:406-756-2241
Mailing Address - Fax:406-758-7062
Practice Address - Street 1:60 FOUR MILE DR STE 10
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2663
Practice Address - Country:US
Practice Address - Phone:406-756-2241
Practice Address - Fax:406-758-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty