# WHITEHALL MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124013719
- **Authorized official:** GAYLE FAYE SACRY M.D. (GENERAL PARTNER)
- **Authorized official phone:** (406) 287-3003

## Contact information

- **Practice address:** 108 W 1ST ST, WHITEHALL, MT 59759-0339
- **Practice address phone:** (406) 287-3003
- **Practice address fax:** (406) 287-3014
- **Mailing address:** PO BOX 339, 108 FIRST ST W, WHITEHALL, MT 59759-0339
- **Mailing address phone:** (406) 287-3003
- **Mailing address fax:** (406) 287-3014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2005
- **Last updated:** 10/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 184739200 | FEDERAL WORK COMP CLINIC | MT |
| 01 | — | 27D0410762 | PRACTICE CLIA ID | MT |
| 05 | — | 9989993 | — | MT |