Organization · Type 2 NPI

Providence Health & Services MT

Cardiovascular Disease Physician · Deer Lodge, MT

NPI number 1407013261 Active

Practice location

1101 Texas Ave
Deer Lodge, MT 59722-1828

Call (406) 846-1722 Map

Fax (406) 329-5606

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Cardiovascular Disease Physician Primary	207RC0000X	None listed
Interventional Cardiology Physician	207RI0011X	None listed
Pulmonary Disease Physician	207RP1001X	None listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

5 other providers at this address

NPI record

NPI: 1407013261
Entity type: Organization (Type 2)
Issued: May 20, 2008
Last updated: Jun 20, 2025
Status: Active
Subpart: Yes of Providence Health & Services

Other names

<unavail>
PMG MT Ihi Deer Lodge · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary Enrollment
(425) 358-9786

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407013261

Providence Health & Services MT's National Provider Identifier is 1407013261, issued on May 20, 2008. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Deer Lodge, MT. The record was last updated on Jun 20, 2025.