Provider Demographics
NPI:1831399864
Name:MCKAMEY, MITCHELL S (DO)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:MCKAMEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:ULM
Mailing Address - State:MT
Mailing Address - Zip Code:59485-0395
Mailing Address - Country:US
Mailing Address - Phone:406-866-3165
Mailing Address - Fax:
Practice Address - Street 1:1400 29TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5315
Practice Address - Country:US
Practice Address - Phone:406-454-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12644207L00000X
MO2011009252207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology