East Slope Family Practice Pllc | |
900 6th St Sw Ste 2 Great Falls MT 59404-3207 | |
(406) 781-3323 | |
Not Available |
Full Name | East Slope Family Practice Pllc |
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Speciality | Clinic/Center |
Location | 900 6th St Sw Ste 2, Great Falls, Montana |
Authorized Official Name and Position | Jeremiah L Watt (BUSINESS OWNER) |
Authorized Official Contact | 4067813323 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Slope Family Practice Pllc 900 6th St Sw Suite 2 Great Falls MT 59404-3207 Ph: (406) 727-3242 | East Slope Family Practice Pllc 900 6th St Sw Ste 2 Great Falls MT 59404-3207 Ph: (406) 781-3323 |
NPI Number | 1801273636 |
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Provider Enumeration Date | 04/30/2015 |
Last Update Date | 07/15/2015 |
Medicare PECOS PAC ID | 9335452432 |
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Medicare Enrollment ID | O20150720000014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801273636 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | 1670537 (Montana) | Primary |
Provider Name | Jeremiah L Watt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336572205 PECOS PAC ID: 4385879881 Enrollment ID: I20131107001670 |
Provider Name | Amanda Marie Engman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912568692 PECOS PAC ID: 6608103452 Enrollment ID: I20190816000720 |
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