Provider Demographics
NPI:1447209184
Name:MONTANA NEPHROLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:MONTANA NEPHROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:406-248-5511
Mailing Address - Street 1:2411 VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2491
Mailing Address - Country:US
Mailing Address - Phone:406-248-5511
Mailing Address - Fax:406-248-5540
Practice Address - Street 1:2411 VILLAGE LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2491
Practice Address - Country:US
Practice Address - Phone:406-248-5511
Practice Address - Fax:406-248-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000084753Medicare PIN