Provider Demographics
NPI:1609044965
Name:TIMOTHY F. BURKE, M.D. P. C.
Entity Type:Organization
Organization Name:TIMOTHY F. BURKE, M.D. P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-721-9999
Mailing Address - Street 1:2835 FORT MISSOULA RD STE 305
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7424
Mailing Address - Country:US
Mailing Address - Phone:406-721-9999
Mailing Address - Fax:406-721-9756
Practice Address - Street 1:2835 FORT MISSOULA RD STE 305
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7424
Practice Address - Country:US
Practice Address - Phone:406-721-9999
Practice Address - Fax:406-721-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7313207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP00075427OtherRAILROAD MEDICARE
MT1922161397OtherNPI
MT0021697Medicaid
MT00005941OtherBLUE CROSS BLUE SHIELD
MT0021697Medicaid