Organization
BIGFORK MEDICAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS G JENKO MD (PRESIDENT)
(406) 837-5541
Entity
Organization
Contact information
Practice address
8299 MT HIGHWAY 35, BIGFORK, MT 59911-3583
(406) 837-5541
(406) 837-5543
Mailing address
8299 MT HIGHWAY 35, BIGFORK, MT 59911-3583
(406) 837-5541
(406) 837-5543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4682
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067171
—
MT
05
—
0149345
—
MT
01
—
16140
BLUESHIELD OF MONTANA
MT
01
—
92136
BLUESHIELD OF MONTANA
MT
Enumeration date
04/10/2007
Last updated
11/05/2007
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