Provider Demographics
NPI:1124388426
Name:LIZOTTE, MICHELLE M (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:LIZOTTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 978
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-0978
Mailing Address - Country:US
Mailing Address - Phone:406-932-7100
Mailing Address - Fax:406-932-7102
Practice Address - Street 1:225 BIG TIMBER LOOP RD
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7646
Practice Address - Country:US
Practice Address - Phone:406-932-7100
Practice Address - Fax:406-932-7102
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-9381207Q00000X
MT41818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine