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Organization
WHITEHALL MEDICAL CLINIC
Active
Organization
WHITEHALL MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE FAYE SACRY M.D. (GENERAL PARTNER)
(406) 287-3003
Entity
Organization
Contact information
Practice address
108 W 1ST ST, WHITEHALL, MT 59759-0339
(406) 287-3003
(406) 287-3014
Mailing address
PO BOX 339, 108 FIRST ST W, WHITEHALL, MT 59759-0339
(406) 287-3003
(406) 287-3014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184739200
FEDERAL WORK COMP CLINIC
MT
01
—
27D0410762
PRACTICE CLIA ID
MT
05
—
9989993
—
MT
Enumeration date
09/20/2005
Last updated
10/24/2019
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