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 provides Neurological Surgery Physician services 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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