Provider Demographics
NPI:1225162589
Name:MANHATTAN MEDICAL SERVICES
Entity Type:Organization
Organization Name:MANHATTAN MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELPS
Authorized Official - Suffix:
Authorized Official - Credentials:BSCS
Authorized Official - Phone:406-285-3251
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:MT
Mailing Address - Zip Code:59741-0350
Mailing Address - Country:US
Mailing Address - Phone:406-284-3393
Mailing Address - Fax:406-284-4023
Practice Address - Street 1:207 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:MT
Practice Address - Zip Code:59741
Practice Address - Country:US
Practice Address - Phone:406-284-3393
Practice Address - Fax:406-284-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT117363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTR95862Medicare UPIN
MT273827Medicare Oscar/Certification