Organization
BOZEMAN HEALTH DEACONESS HOSPITAL
Active
Other names
Bozeman Health Internal Medicine Clinic Medicaid Passport NPI
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD K LUDFORD (CFO)
(406) 414-1036
Entity
Organization
Contact information
Practice address
937 HIGHLAND BLVD STE 5410, BOZEMAN, MT 59715-6916
(406) 414-2400
Mailing address
915 HIGHLAND BLVD STE 2170, BOZEMAN, MT 59715-6902
(406) 414-5552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/01/2019
Last updated
11/19/2024
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