Organization
FORSYTH FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE DENISE DEERING (OFFICE MANAGER)
(406) 346-2916
Entity
Organization
Contact information
Practice address
281 N 17TH AVENUE, FORSYTH, MT 59327-0410
(406) 346-2916
(406) 346-7478
Mailing address
PO BOX 410, 281 N 17TH AVENUE, FORSYTH, MT 59327-0410
(406) 346-2916
(406) 346-7478
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4811
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0053329
—
MT
01
—
CJ4988
RAILROAD MEDICARE EDI #
MT
Enumeration date
11/21/2006
Last updated
02/20/2008
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