Provider Demographics
NPI:1811912991
Name:EDWARDS, TERRY SCOTT (MD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:SCOTT
Last Name:EDWARDS
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 1:4535 VALLEY COMMONS DR STE 104
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4161
Mailing Address - Country:US
Mailing Address - Phone:406-404-1525
Mailing Address - Fax:406-548-9777
Practice Address - Street 1:4535 VALLEY COMMONS DR STE 104
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4161
Practice Address - Country:US
Practice Address - Phone:406-404-1525
Practice Address - Fax:406-548-9777
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
98325OtherBCBS
MT82943Medicaid
G55308Medicare UPIN
MT82943Medicaid