Provider Demographics
NPI:1497357529
Name:CRAZY MOUNTAIN FAMILY MEDICINE
Entity Type:Organization
Organization Name:CRAZY MOUNTAIN FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-672-6082
Mailing Address - Street 1:PO BOX 978
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-0978
Mailing Address - Country:US
Mailing Address - Phone:406-932-7100
Mailing Address - Fax:406-932-7102
Practice Address - Street 1:225 BIG TIMBER LOOP RD
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7646
Practice Address - Country:US
Practice Address - Phone:406-932-7100
Practice Address - Fax:406-932-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care