Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services Mt

Organization Neurological Surgery Physician · NPI 1720477953

Providence Health & Services Mt is a Neurological Surgery Physician in Missoula, Montana. Licensed in Montana. Registered with an NPI since 2015.

Licensed in
MT
In the registry since
2015

Practice location Address checks out

500 W Broadway St
Missoula, MT 59802-4008
Phone: (406) 327-1918
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence 9574 (MT)

Record details

NPI number1720477953
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Medical Group Montana; Providence Medical Group Montana Neurosurgical Specialists; Providence Medical Group Montana Neurosurgical Specialists
NPI enumeratedJanuary 12, 2015
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 31001 - 4114, Pasadena, CA 91110-4114

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