Individual
ORVILLE H MANN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(800) 461-3981
(801) 733-5872
Mailing address
88 SABER CIRCLE, BOZEMAN, MT 59715
(406) 522-0544
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9566
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148784
—
MT
01
—
1343108880000
CHAMPUS
MT
Enumeration date
07/18/2006
Last updated
07/09/2007
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