| Dr Mark Donald Kishbaugh, DMSC, PA-C | |
|
7 Microwave Hill Rd Ste C, Clancy, MT 59634-8001 | |
| (406) 422-0656 | |
| (833) 471-4087 |
| Full Name | Dr Mark Donald Kishbaugh |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 30 Years |
| Location | 7 Microwave Hill Rd Ste C, Clancy, Montana |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467410803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 43812 (Montana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Peters Health | Helena, MT | Hospital |
| Intermountain Health St James Hospital | Butte, MT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hospice Of Montana Iii Llc | 1658715016 | 2 |
| Entity Name | St Peters Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205025145 PECOS PAC ID: 7911814926 Enrollment ID: O20031204001245 |
| Entity Name | Lewis and Clark Emergency Physicians P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083668651 PECOS PAC ID: 0941196497 Enrollment ID: O20040223001126 |
| Entity Name | St Peters Health |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1033354683 PECOS PAC ID: 7911814926 Enrollment ID: O20090202000564 |
| Entity Name | Scl Health Medical Group-butte LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477869600 PECOS PAC ID: 2466633102 Enrollment ID: O20110301000023 |
| Entity Name | Chronic Disease Management LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154032472 PECOS PAC ID: 1153787064 Enrollment ID: O20230519000391 |
| Entity Name | Hospice of Montana III LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336149517 PECOS PAC ID: 1658715016 Enrollment ID: O20260408003142 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Donald Kishbaugh, DMSC, PA-C Po Box 312, Jefferson City, MT 59638-0312 Ph: (406) 224-2244 | Dr Mark Donald Kishbaugh, DMSC, PA-C 7 Microwave Hill Rd Ste C, Clancy, MT 59634-8001 Ph: (406) 422-0656 |