Organization
BOZEMAN HEALTH DEACONESS HOSPITAL
Active
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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