Organization
MARK IBSEN INC
Active
Other names
Urgent Care Plus
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S IBSEN M.D. (OWNER)
(406) 513-1052
Entity
Organization
Contact information
Practice address
39 NEILL AVE, HELENA, MT 59601-3330
(406) 513-1052
(406) 513-1054
Mailing address
39 NEILL AVE, HELENA, MT 59601-3330
(406) 513-1052
(406) 513-1054
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
7378
MT
207Q00000X
Family Medicine Physician
7378
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080499
MEDICARE ID-TYPE UNSPECIFIED
MT
05
—
104958
—
MT
Enumeration date
12/16/2009
Last updated
05/04/2010
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