Provider Demographics
NPI:1609171693
Name:MOUNTAIN SURGICAL ARTS PC
Entity Type:Organization
Organization Name:MOUNTAIN SURGICAL ARTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KONTNY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:406-513-1962
Mailing Address - Street 1:PO BOX 7305
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-7305
Mailing Address - Country:US
Mailing Address - Phone:406-513-1962
Mailing Address - Fax:406-204-0233
Practice Address - Street 1:3130 SADDLE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8637
Practice Address - Country:US
Practice Address - Phone:406-513-1962
Practice Address - Fax:406-204-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G39559Medicare UPIN