# KALISPELL REGIONAL MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Logan Health Urology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124618319
- **Authorized official:** WILLIAM D GIBSON (GENERAL COUNSEL)
- **Authorized official phone:** (406) 752-1724

## Contact information

- **Practice address:** 350 HERITAGE WAY STE 2300, KALISPELL, MT 59901-3167
- **Practice address phone:** (406) 890-7432
- **Practice address fax:** (406) 890-7402
- **Mailing address:** 350 HERITAGE WAY STE 2300, KALISPELL, MT 59901-3167
- **Mailing address phone:** (406) 890-7432
- **Mailing address fax:** (406) 890-7402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/21/2021
- **Last updated:** 01/21/2021