Provider Demographics
NPI:1306379037
Name:GENERATIONS FAMILY MEDICINE AND OBSTETRICS
Entity Type:Organization
Organization Name:GENERATIONS FAMILY MEDICINE AND OBSTETRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-541-9222
Mailing Address - Street 1:2825 FORT MISSOULA RD STE 115
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7403
Mailing Address - Country:US
Mailing Address - Phone:406-541-9222
Mailing Address - Fax:406-541-9223
Practice Address - Street 1:2825 FORT MISSOULA RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-529-3690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty