Provider Demographics
NPI:1609965987
Name:SALISBURY, JESSIE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:J
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SO. CRYSTAL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1506
Mailing Address - Country:US
Mailing Address - Phone:406-496-3600
Mailing Address - Fax:406-496-3653
Practice Address - Street 1:435 SO. CRYSTAL
Practice Address - Street 2:SUITE 300
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1506
Practice Address - Country:US
Practice Address - Phone:406-496-3600
Practice Address - Fax:406-496-3653
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0019006Medicaid
MT000008561OtherBCBS
MT0019006Medicaid