Jim Ford
Individual provider Active NPI Driver · Helena, MT
NPI 1548097744 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1548097744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 0107219634123 (MT)
- Practice address
- 510 Dearborn Ave
Helena, MT 59601-2761 - Phone
- (406) 439-2108
- NPI assigned
- Sep 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0107219634123 | MT | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 0107219634123 | MT | Yes |
Addresses
Primary practice location
510 Dearborn Ave
Helena, MT 59601-2761
Mailing address
510 Dearborn Ave
Helena, MT 59601-2761
Phone (406) 439-2108
Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. 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.