Mountain Country Women's Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

7268 Issued in MT

Legal business name

MOUNTAIN COUNTRY WOMEN'S CLINIC

Practice address

207 S Main St
Livingston, MT 59047-3016

Phone

(406) 222-7555

NPI assigned

Feb 5, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Susan Marie Wicklund, MDNPI 1487624953

Title

President

Phone

(406) 222-7555

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan M Wicklund, M.D.

  • General Practice Physician
  • Livingston, MT
  • NPI 1487624953
  NPD (past) Authorized official

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1902045420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1780",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590474702",
            "telephone_number": "406-222-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S MAIN ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590473016",
            "telephone_number": "406-222-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COUNTRY WOMEN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "WICKLUND",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-222-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MT",
            "license": "7268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Dean Miller, P.T., CPED
• Nancy Milligan, MT
• Montanesthesia PLLC
• Gabriela Morie, FNP
• Ellen Elizabeth Morris, LCSW
• Mountain Wellness Therapy LLC
• Deeann Marie Myer, MS, LCSW
• Diane Nash Boehm, L.C.P.C.
• Kieran Lyssa Nashan
• Emma Taylor Neal, MS OTR/L

• General Practice Physician in Livingston, MT
• Providers in Livingston, MT by specialty
• General Practice Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.