Organization
ORTHOPEDICS OF CENTRAL MT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM M IANNACONE MD (PRESIDENT)
(406) 538-1456
Entity
Organization
Contact information
Practice address
310 WENDELL AVENUE, SUITE 5, LEWISTOWN, MT 59457-2267
(406) 538-1456
(406) 538-1422
Mailing address
310 WENDELL AVENUE, SUITE 5, LEWISTOWN, MT 59457-2267
(406) 538-1456
(406) 538-1422
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000144274
—
MT
01
—
610577800
DEPARTMENT OF LABOR
MT
Enumeration date
11/17/2006
Last updated
11/07/2007
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