Provider Demographics
NPI:1780665844
Name:WEBB, BRYAN K (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:K
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:435 S CRYSTAL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1506
Mailing Address - Country:US
Mailing Address - Phone:406-496-3600
Mailing Address - Fax:406-496-3653
Practice Address - Street 1:435 S CRYSTAL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1506
Practice Address - Country:US
Practice Address - Phone:406-496-3600
Practice Address - Fax:406-496-3653
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2012-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT8072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT00 21437Medicaid
MT00 21437Medicaid
F16043Medicare UPIN