Provider Demographics
NPI:1790994010
Name:PERRY K. BIRKY MD, PC
Entity Type:Organization
Organization Name:PERRY K. BIRKY MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERRY K. BIRKY, M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BIRKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-250-0332
Mailing Address - Street 1:202 CONWAY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3112
Mailing Address - Country:US
Mailing Address - Phone:406-752-5656
Mailing Address - Fax:406-755-0971
Practice Address - Street 1:202 CONWAY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3112
Practice Address - Country:US
Practice Address - Phone:406-751-5662
Practice Address - Fax:406-755-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4586207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTD07941Medicare UPIN