Provider Demographics
NPI:1972550051
Name:SOUTH HILLS INTERNAL MEDICINE ASSOCIATES PLLP
Entity type:Organization
Organization Name:SOUTH HILLS INTERNAL MEDICINE ASSOCIATES PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-442-2205
Mailing Address - Street 1:2525 COLONIAL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4902
Mailing Address - Country:US
Mailing Address - Phone:406-495-7260
Mailing Address - Fax:
Practice Address - Street 1:301 SADDLE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8098
Practice Address - Country:US
Practice Address - Phone:406-442-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty