Elkhorn Mountain Health Services Inc
Organization Active NPI Family Medicine Physician · Boulder, MT
NPI 1043396054 · NPPES record last updated Apr 29, 2008
Key facts
- NPI
- 1043396054
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ELKHORN MOUNTAIN HEALTH SERVICES INC
- Practice address
- 214 South Main
Boulder, MT 59632 - Phone
- (406) 225-4201
- Fax
- (406) 225-9161
- NPI assigned
- Oct 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Lee S Swanson
- Title
- Vice President
- Phone
- (406) 225-4201
Practitioners 17
-
Danielle Redfield, FNP-C
-
Diana Corzine, M.D.
-
Scott M. Dreblow, PA-C
-
Linda Rae Hanson, PA-C
-
Lori Jane Lagerquist, PA-C
-
Beverly Colleen Roope, FNP-C
-
Cheryl A Cavalli, D.O.
-
Jay Austin Clark, M.D.
-
Marwan Massouh, MD
National Provider Directory
Locations
721 N Miles Ave
Hardin, MT 59034
Phone (406) 665-4103
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
214 South Main
Boulder, MT 59632
Mailing address
214 South Main
Boulder, MT 59632-0028
Phone (406) 225-4201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 720291 | Medicaid | MT |
Other names
- Boulder Medical Clinic Inc
Other providers in Boulder, MT
- Veronica J Champer
- City of Boulder
- County of Jefferson
- Ivy Donath
- Elkhorn Family Dental, LLC
- Elkhorn Pharmacy Inc
- Elkhorn Telehealth Psychiatric Services, LLC
- Kristin Nicole Fearon
- Abbi A Fetters
- Connie L Grenz
All providers in Boulder, MT · Family Medicine Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.