Organization
GREAT FALLS GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD D SPENCER M.D. (OWNER)
(406) 455-5870
Entity
Organization
Contact information
Practice address
1300 28TH ST S, SUITE 3, GREAT FALLS, MT 59405-5296
(406) 455-5870
(406) 731-8079
Mailing address
1300 28TH ST S, SUITE 3, GREAT FALLS, MT 59405-5296
(406) 455-5870
(406) 731-8079
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5199
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48994
—
MT
01
—
99930
BLUE CROSS
MT
Enumeration date
05/07/2007
Last updated
06/18/2010
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