Provider Demographics
NPI: | 1376598714 |
---|---|
Name: | BILLINGS CLINIC |
Entity Type: | Organization |
Organization Name: | BILLINGS CLINIC |
Other - Org Name: | BILLINGS CLINIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KATHLEEN |
Authorized Official - Middle Name: | ROSSIE |
Authorized Official - Last Name: | QUINONES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-435-6445 |
Mailing Address - Street 1: | PO BOX 35100 |
Mailing Address - Street 2: | |
Mailing Address - City: | BILLINGS |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59107-5100 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-238-2500 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 801 N 29TH ST |
Practice Address - Street 2: | |
Practice Address - City: | BILLINGS |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59101-0905 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-238-2500 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | BILLINGS CLINIC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-05-24 |
Last Update Date: | 2023-01-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207K00000X, 207N00000X, 207ND0101X, 207Q00000X, 207R00000X, 207RC0000X, 207RC0200X, 207RE0101X, 207RG0100X, 207RG0300X, 207RH0003X, 207RI0011X, 207RI0200X, 207RN0300X | ||
MT | 13445 | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MT | 0415688 | Other | MDCD PIN |
MT | CI3483 | Medicare PIN | |
WY | CI5720 | Medicare PIN | |
MT | 1153260003 | Medicare NSC | |
MT | 0415688 | Other | MDCD PIN |