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Individual

DR. KEITH D BORTNEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1401 25TH ST S STE 1, GREAT FALLS, MT 59405-5183
(406) 455-3650
(406) 731-8318
Mailing address
1401 25TH ST S STE 1, GREAT FALLS, MT 59405-5183
(406) 455-3650
(406) 731-8318

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7067
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000003721
BLUE CROSS BLUE SHIELD
05
0094796
MT
01
0206209
WASHINGTON L&I
01
200012385
RAILROAD MEDICARE
MT
01
810347861
CHAMPUS
MT
01
810347861003
EBMS
MT
Enumeration date
06/10/2006
Last updated
04/05/2024
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