# EASTERN PLAINS-CLINIC OF UROLOGY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1760688238
- **Authorized official:** DR. MICHAEL ERVIN KUGLITSCH MD (OWNER)
- **Authorized official phone:** (920) 623-9970

## Contact information

- **Practice address:** 630 W MERCURY ST, BUTTE, MT 59701-1510
- **Practice address phone:** (920) 623-9970
- **Practice address fax:** (920) 623-9989
- **Mailing address:** 630 W MERCURY ST, BUTTE, MT 59701-1510
- **Mailing address phone:** (920) 623-9970
- **Mailing address fax:** (920) 623-9989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 7089 | MT | Yes |

## Other

- **Enumeration date:** 06/22/2007
- **Last updated:** 03/31/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0020103002 | — | ID |
| 05 | — | 0081226 | — | MT |
| 05 | — | 30673100 | — | WI |