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Individual

DR. JACK O FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
700 W GOLD ST, BUTTE, MT 59701-2320
(406) 782-6391
(406) 782-6585
Mailing address
700 W GOLD ST, BUTTE, MT 59701-2320
(406) 782-6391
(406) 782-6585

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
10733
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0095438
MT
01
99955
BLUE CROSS BLUE SHIELD
MT
Enumeration date
09/04/2006
Last updated
07/08/2007
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