Providence Health & Services Mt

NPI #1154562981 in Missoula, Montana

Provider Information

NPI Number: 1154562981
Entity Type: Organization
Organization Name: Providence Health & Services Mt
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES
Primary Specialty: Pediatrics
Enumeration Date: Mar 6, 2009
Last Updated: May 6, 2025

Practice Location

Address: 500 W BROADWAY ST
City: Missoula
State: Montana
ZIP Code: 59802-4096
Phone: (406) 327-1613

Authorized Official

Name: DONALD W ANDERSON JR.
Title: ASSISTANT SECRETARY ENROLLMENT
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Hospitalist	208M00000X
Pediatrics	208000000X	Primary

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