| NPI | 1710541131 |
|---|---|
| Other Name | BOZEMAN HEALTH INTERNAL MEDICINE CLINIC MEDICAID PASSPORT NPI |
| Entity Type | Organization |
| Authorized Contact | BRAD K LUDFORD CFO 406-414-1036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2024-11-19 |