Individual
DR. KELLY L BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
925 HIGHLAND BLVD, STE 1200, BOZEMAN, MT 59715-6900
(406) 587-0704
(406) 587-1147
Mailing address
925 HIGHLAND BLVD, SUITE 1100, BOZEMAN, MT 59715-6900
(406) 414-4550
(406) 414-4599
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
6438
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085748
—
MT
Enumeration date
07/01/2005
Last updated
09/18/2017
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