Individual provider · Type 1 NPI

Joshua Ebenezer Landavaso I, MD

Student in an Organized Health Care Education/Training Program · Great Falls, MT

NPI number 1053014738 Active

Practice location

2800 11th Ave S Ste 24
Great Falls, MT 59405-5263

Call (406) 771-6300 Map

Fax (406) 731-8318

Mailing address

PO Box 6010
Great Falls, MT 59406-6010

Other practice locations

  • 1101 26th St S, Great Falls, MT 59405-5161 · (580) 481-4130

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X173499 (MT)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1053014738

Joshua Ebenezer Landavaso I, MD's National Provider Identifier is 1053014738, issued on Mar 23, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Great Falls, MT. The record was last updated on Jun 2, 2026.