Individual
SCOTT RICHARD JAHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3 MERIDIAN CT STE 2, KALISPELL, MT 59901-4240
(406) 755-4488
Mailing address
3 MERIDIAN CT STE 2, KALISPELL, MT 59901-4240
(406) 755-4488
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
10947
MT
208VP0014X
Interventional Pain Medicine Physician
Primary
10947
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4976249-11
—
MI
01
—
554111654
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/31/2006
Last updated
03/26/2020
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