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

Providence Health & Services Mt

Organization Internal Medicine Physician · NPI 1730325440

Providence Health & Services Mt is an Internal Medicine Physician in Missoula, Montana. Licensed in Montana. Registered with an NPI since 2008.

Licensed in
MT
In the registry since
2008
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2819 Great Northern Loop Ste 200
Missoula, MT 59808-1750
Phone: (406) 543-1197
Fax: (406) 543-0515
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 0411866 (MT)

Record details

NPI number1730325440
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services
Authorized official Kirk Bodlovic — Cfo · (406) 327-1918
Other names Pmg Mt Montana Internal Med
NPI enumeratedDecember 30, 2008
Last updated in NPPESNovember 22, 2013
Mailing addressPo Box 12, Liberty Lake, WA 99019-0012

Other providers in Missoula