Organization · Type 2 NPI

Providence Health & Services MT

Neurological Surgery Physician · Missoula, MT

NPI number 1720477953 Active

Practice location

500 W Broadway St
Missoula, MT 59802-4008

Call (406) 327-1918 Map

Mailing address

PO Box 31001 - 4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Neurological Surgery Physician Primary	207T00000X	9574 (MT)

Neurological Surgery Physician: A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the opera…

222 other providers at this address

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NPI record

NPI: 1720477953
Entity type: Organization (Type 2)
Issued: Jan 12, 2015
Last updated: May 7, 2025
Status: Active

Other names

<unavail>
Providence Medical Group Montana · doing business as
Providence Medical Group Montana Neurosurgical Specialists · doing business as
Providence Medical Group Montana Neurosurgical Specialists · doing business as

Authorized official

Mr. Donald W Anderson
Assistant Secretary Enrollments
(425) 358-9786

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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 1720477953

Providence Health & Services MT's National Provider Identifier is 1720477953, issued on Jan 12, 2015. The primary taxonomy on file is Neurological Surgery Physician (207T00000X), and the practice location is in Missoula, MT. The record was last updated on May 7, 2025.