Individual
DR. MERLIN BARDETT FAUSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2831 FORT MISSOULA RD STE 232, MISSOULA, MT 59804-7479
(406) 523-5650
(855) 823-5532
Mailing address
3405 RAVENWOOD LN, MISSOULA, MT 59803-3219
(406) 360-7941
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
336166-1205
UT
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
336166-1205
UT
207VM0101X
Maternal & Fetal Medicine Physician
Primary
30616
MT
207VM0101X
Maternal & Fetal Medicine Physician
MD.13790R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1126148-00
—
WY
05
—
87041014401
—
UT
Enumeration date
03/11/2007
Last updated
11/16/2025
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