Provider Demographics
NPI:1346276516
Name:KONTNY, DEBRA ANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANNE
Last Name:KONTNY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 SADDLE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8637
Mailing Address - Country:US
Mailing Address - Phone:406-513-1962
Mailing Address - Fax:
Practice Address - Street 1:3130 SADDLE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8637
Practice Address - Country:US
Practice Address - Phone:406-513-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3102208600000X
WAOP00001682208600000X
IDO-0417208600000X
MT11311208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ349416Medicaid
AZ349416Medicaid