# BOZEMAN HEALTH DEACONESS HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bozeman Health Cottonwood Primary Care Medicaid Passport NPI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316531320
- **Authorized official:** BRAD K LUDFORD (CFO)
- **Authorized official phone:** (406) 414-1036

## Contact information

- **Practice address:** 875 S COTTONWOOD RD STE 300, BOZEMAN, MT 59718-4208
- **Practice address phone:** (406) 414-4100
- **Mailing address:** 915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
- **Mailing address phone:** (406) 414-5552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/22/2021
- **Last updated:** 11/19/2024