Provider Demographics
NPI:1275636524
Name:SURGICAL SOLUTIONS OF SOUTHWEST MONTANA PC
Entity Type:Organization
Organization Name:SURGICAL SOLUTIONS OF SOUTHWEST MONTANA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-496-3500
Mailing Address - Street 1:PO BOX 3667
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59702-3667
Mailing Address - Country:US
Mailing Address - Phone:406-496-3500
Mailing Address - Fax:406-496-3515
Practice Address - Street 1:435 S CRYSTAL ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1506
Practice Address - Country:US
Practice Address - Phone:406-496-3500
Practice Address - Fax:406-496-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty