Provider Demographics
NPI:1063639029
Name:MARIA LYN HUNTLEY
Entity Type:Organization
Organization Name:MARIA LYN HUNTLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-457-4366
Mailing Address - Street 1:2525 E BROADWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601
Mailing Address - Country:US
Mailing Address - Phone:406-457-4366
Mailing Address - Fax:406-457-4367
Practice Address - Street 1:2525 E BROADWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-457-4366
Practice Address - Fax:406-457-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Single Specialty