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

Mallory Koula, MD

Individual provider Diagnostic Radiology Physician · NPI 1467987727

Mallory Koula, MD is a Family Practice in Missoula, Montana. Graduated from Medical College of Wisconsin in 2017, 9 years ago. Practices with Providence Health and Services Mt, a 358-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Montana and Utah.

Years since qualifying
9
Trained at
Medical College of Wisconsin
Licensed in
MT, UT
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Phone: (406) 327-1850
Fax: (406) 327-1875
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 30 N 1900 E Rm 1a071, Salt Lake City, UT 84132-0002 — (801) 581-2121

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MED-PHYS-LIC-114887 (MT)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 10983218-1205 (UT)

Record details

NPI number1467987727
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 25, 2017
Last updated in NPPESSeptember 27, 2022
Certification dateSeptember 27, 2022
Mailing addressPo Box 12, Liberty Lake, WA 99019-0012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2017 (9 years in practice)
Group practice Providence Health And Services Mt — 358 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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