Provider Demographics
NPI:1831298348
Name:BORN, SCOT E (MD)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:E
Last Name:BORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1900
Mailing Address - Country:US
Mailing Address - Phone:406-752-7406
Mailing Address - Fax:406-752-7544
Practice Address - Street 1:75 CLAREMONT ST STE H
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3500
Practice Address - Country:US
Practice Address - Phone:406-752-7406
Practice Address - Fax:406-752-7544
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10318207R00000X, 207RN0300X
MT104392207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT95265OtherBCBS
P00029737OtherRR MEDICARE
MT62220Medicaid
MT95265OtherBCBS
MT62220Medicaid