Individual
BRUCE DEVIN MIKESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 6TH AVE SW, RONAN, MT 59864-2634
(406) 676-4441
(406) 676-0835
Mailing address
20700 EDITH PEAK RD, HUSON, MT 59846-9603
(406) 626-5676
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
7984
MT
207Q00000X
Family Medicine Physician
7984
MT
207QS0010X
Sports Medicine (Family Medicine) Physician
7984
MT
Other
Enumeration date
07/05/2006
Last updated
12/18/2014
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