Organization
BOZEMAN HEALTH DEACONESS HOSPITAL
Active
Other names
Bozeman Health Family Medicine Clinic Medicaid Passport NPI
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD K LUDFORD (CFO)
(406) 414-1036
Entity
Organization
Contact information
Practice address
935 HIGHLAND BLVD STE 2200, BOZEMAN, MT 59715-6915
(406) 414-5700
Mailing address
915 HIGHLAND BLVD STE 2170, BOZEMAN, MT 59715-6902
(406) 414-5552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/01/2019
Last updated
11/19/2024
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