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Organization
EASTERN PLAINS-CLINIC OF UROLOGY, LLC
Active
Organization
EASTERN PLAINS-CLINIC OF UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ERVIN KUGLITSCH MD (OWNER)
(920) 623-9970
Entity
Organization
Contact information
Practice address
630 W MERCURY ST, BUTTE, MT 59701-1510
(920) 623-9970
(920) 623-9989
Mailing address
630 W MERCURY ST, BUTTE, MT 59701-1510
(920) 623-9970
(920) 623-9989
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
7089
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020103002
—
ID
05
—
0081226
—
MT
05
—
30673100
—
WI
Enumeration date
06/22/2007
Last updated
03/31/2008
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