| Alpine Family Medicine Pc | |
|
734 9th St W Suite 12 Columbia Falls MT 59912-3859 | |
| (406) 892-1011 | |
| (406) 892-2108 |
| Full Name | Alpine Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 734 9th St W, Columbia Falls, Montana |
| Authorized Official Name and Position | Derek Gedlaman (CEO) |
| Authorized Official Contact | 4068921011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Family Medicine Pc 734 9th St W Suite 12 Columbia Falls MT 59912-3859 Ph: (406) 892-1011 | Alpine Family Medicine Pc 734 9th St W Suite 12 Columbia Falls MT 59912-3859 Ph: (406) 892-1011 |
| NPI Number | 1861523649 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/26/2008 |
| Medicare PECOS PAC ID | 7416943451 |
|---|---|
| Medicare Enrollment ID | O20040423000716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861523649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10336 (Montana) | Primary |
| 363AM0700X | Physician Assistant - Medical | 312 (Montana) | Secondary |
| Provider Name | Derek A Gedlaman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902895329 PECOS PAC ID: 2466446661 Enrollment ID: I20040412000667 |
| Provider Name | Kelly A Coloff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205094398 PECOS PAC ID: 6103990486 Enrollment ID: I20080805000182 |
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