Provider Demographics
NPI:1922105808
Name:DEMING, JAMES C (EDD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:DEMING
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 HIGHLAND BLVD
Mailing Address - Street 2:STE 2150
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6904
Mailing Address - Country:US
Mailing Address - Phone:406-586-7474
Mailing Address - Fax:406-586-7474
Practice Address - Street 1:935 HIGHLAND BLVD
Practice Address - Street 2:STE 2150
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6904
Practice Address - Country:US
Practice Address - Phone:406-586-7474
Practice Address - Fax:406-586-7474
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0138103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0490867Medicaid
MT52260OtherBLUE CROSS BLUE SHIELD
MT5093Medicare ID - Type UnspecifiedMEDICARE