Mark Paul, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT5294 Issued in MT

Practice address

3800 Eastside Hwy
Stevensville Community Medical Center
Stevensville, MT 59870

Phone

(406) 777-2775

Fax

(406) 777-2796

NPI assigned

Aug 9, 2006

Last updated

Feb 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1679583892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16900",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598086900",
            "telephone_number": "406-327-4620",
            "fax_number": "406-549-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 EASTSIDE HWY",
            "address_2": "STEVENSVILLE COMMUNITY MEDICAL CENTER",
            "city": "STEVENSVILLE",
            "state": "MT",
            "postal_code": "59870",
            "telephone_number": "406-777-2775",
            "fax_number": "406-777-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MT5294",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "MT5294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076700",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000095960",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Madison Kurtz Parell, MS, CCC-SLP
• McKenzie Pearson
• Samuel Cabeen Peters, CRT
• Ann M Petschauer, PCLC, ACLC
• Providence Health & Services Mt
• Providence Health & Services Mt (PMG MT Lifespan Family Med)

• Family Medicine Physician in Stevensville, MT
• Providers in Stevensville, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.