Eastern Plains-Clinic of Urology, LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

7089 Issued in MT

Legal business name

EASTERN PLAINS-CLINIC OF UROLOGY, LLC

Practice address

630 W Mercury St
Butte, MT 59701-1510

Phone

(920) 623-9970

Fax

(920) 623-9989

NPI assigned

Jun 22, 2007

Last updated

Mar 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Ervin Kuglitsch, MD

Title

Owner

Phone

(920) 623-9970

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1760688238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W MERCURY ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011510",
            "telephone_number": "920-623-9970",
            "fax_number": "920-623-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MERCURY ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011510",
            "telephone_number": "920-623-9970",
            "fax_number": "920-623-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PLAINS-CLINIC OF UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "KUGLITSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ERVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-623-9970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "7089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081226",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30673100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020103002",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Butte, MT
• Providers in Butte, MT by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.