Individual
BRUCE SPEICHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6 13TH AVE E, POLSON, MT 59860
(406) 883-5680
(406) 883-8910
Mailing address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
(406) 883-8910
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
68487
MT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
02000995
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181694
ANTHEM
IN
05
—
100318640A
—
IN
05
—
114340109
—
MI
01
—
930101007
RAIL ROAD MEDICARE
IN
Enumeration date
04/06/2006
Last updated
08/31/2018
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