Dr J General Surgery PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

8688 Issued in MT

Legal business name

DR J GENERAL SURGERY PLLC

Practice address

2835 Fort Missoula Rd Ste 306
Missoula, MT 59804-7424

Phone

(406) 541-2570

Fax

(406) 541-2573

NPI assigned

Mar 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristin H Janczewski, MD

Title

Surgeon Practice Administrator

Phone

(406) 541-2570

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013035666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA ROAD STE 306",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59804",
            "telephone_number": "406-541-2570",
            "fax_number": "406-541-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD STE 306",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047424",
            "telephone_number": "406-541-2570",
            "fax_number": "406-541-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR J GENERAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JANCZEWSKI",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SURGEON PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "406-541-2570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MT",
            "license": "8688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062169",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.