Provider Demographics
NPI:1578895207
Name:MORLEDGE FAMILY SURGERY CENTER
Entity Type:Organization
Organization Name:MORLEDGE FAMILY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MORLEDGE-HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-294-1994
Mailing Address - Street 1:1747 POLY DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1728
Mailing Address - Country:US
Mailing Address - Phone:406-294-1994
Mailing Address - Fax:406-294-1996
Practice Address - Street 1:1747 POLY DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1728
Practice Address - Country:US
Practice Address - Phone:406-294-1994
Practice Address - Fax:406-294-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT12340OtherSTATE LICENSE
27D2006512OtherCLIA WAIVER
MT12340OtherSTATE LICENSE