Provider Demographics
NPI:1972720811
Name:KALISPELL GASTROENTEROLOGY,PC
Entity type:Organization
Organization Name:KALISPELL GASTROENTEROLOGY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-752-7441
Mailing Address - Street 1:75 CLAREMONT ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3585
Mailing Address - Country:US
Mailing Address - Phone:406-752-7441
Mailing Address - Fax:406-257-0304
Practice Address - Street 1:75 CLAREMONT ST
Practice Address - Street 2:SUITE F
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3585
Practice Address - Country:US
Practice Address - Phone:406-752-7441
Practice Address - Fax:406-257-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty