Provider Demographics
NPI:1073239323
Name:TRUE NORTH DIRECT PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:TRUE NORTH DIRECT PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:406-530-7439
Mailing Address - Street 1:1986 N 1ST ST STE D
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-3217
Mailing Address - Country:US
Mailing Address - Phone:406-530-7439
Mailing Address - Fax:406-361-8168
Practice Address - Street 1:1986 N 1ST ST STE D
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3217
Practice Address - Country:US
Practice Address - Phone:406-530-7439
Practice Address - Fax:406-361-8168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT25811OtherSTATE MEDICAL LICENSE