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Organization

BOZEMAN HEALTH DEACONESS HOSPITAL

Active
Other names
Bozeman Health Pediatrics 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 5320, BOZEMAN, MT 59715-6916
(406) 414-4900
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5552

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
05/01/2019
Last updated
11/19/2024
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