Provider Demographics
NPI:1356528178
Name:COMPREHENSIVE FAMILY PRACTICE
Entity type:Organization
Organization Name:COMPREHENSIVE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAYTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-455-4470
Mailing Address - Street 1:2519 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5178
Mailing Address - Country:US
Mailing Address - Phone:406-455-4470
Mailing Address - Fax:406-268-0084
Practice Address - Street 1:400 15TH AVE S
Practice Address - Street 2:SUITE 207
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4375
Practice Address - Country:US
Practice Address - Phone:406-455-2538
Practice Address - Fax:406-455-2838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEFIS HEALTHCARE PRACTITIONERS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty