| Mark Ibsen Inc | |
|
39 Neill Ave Helena MT 59601-3330 | |
| (406) 513-1052 | |
| (406) 513-1054 |
| Full Name | Mark Ibsen Inc |
|---|---|
| Speciality | Emergency Medicine - Emergency Medical Services |
| Location | 39 Neill Ave, Helena, Montana |
| Authorized Official Name and Position | Mark S Ibsen (OWNER) |
| Authorized Official Contact | 4065131052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Ibsen Inc 39 Neill Ave Helena MT 59601-3330 Ph: (406) 513-1052 | Mark Ibsen Inc 39 Neill Ave Helena MT 59601-3330 Ph: (406) 513-1052 |
| NPI Number | 1821327008 |
|---|---|
| Provider Enumeration Date | 12/16/2009 |
| Last Update Date | 05/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821327008 | NPI | - | NPPES |
| 104958 | Medicaid | MT | |
| 000080499 | Other | MT | MEDICARE ID-TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7378 (Montana) | Secondary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 7378 (Montana) | Primary |
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