Organization
INFECTIOUS DISEASE SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WILLA CRAIG MBA (BUSINESS MANAGER)
(406) 721-6221
Entity
Organization
Contact information
Practice address
614 W SPRUCE ST, MISSOULA, MT 59802-4002
(406) 327-1666
(406) 329-5606
Mailing address
PO BOX 8897, MISSOULA, MT 59807-8897
(406) 721-6221
(406) 721-6221
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
6638
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154581
—
MT
05
—
1073553491
—
MT
01
—
92275
BCBS
—
01
—
P00185637
RR MEDICARE
—
Enumeration date
06/07/2006
Last updated
05/27/2008
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