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Organization

PROVIDENCE HEALTH & SERVICES MT

Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PROVIDENCE MEDICAL GROUP MONTANA, PMG MT IHI Butte
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization

Contact information

Practice address
435 S CRYSTAL ST STE 240, BUTTE, MT 59701-1523
(406) 496-3602
(406) 496-3110
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
05/26/2009
Last updated
05/07/2025
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