Provider Demographics
NPI:1902843816
Name:CARDIOLOGY CONSULTANTS OF BOZEMAN PC
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF BOZEMAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:DILLARD
Authorized Official - Last Name:ERB
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:406-522-3959
Mailing Address - Street 1:PO BOX 5179
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-5179
Mailing Address - Country:US
Mailing Address - Phone:406-443-1556
Mailing Address - Fax:406-443-4526
Practice Address - Street 1:905 HIGHLAND BLVD
Practice Address - Street 2:SUITE 4330
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6902
Practice Address - Country:US
Practice Address - Phone:406-522-3959
Practice Address - Fax:406-586-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty