Basic Information
| Provider Information | |||||||||
| NPI: | 1295762714 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRAUB | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | GOGAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41276 FLATHEAD VIEW DR | ||||||||
| Address2: | |||||||||
| City: | POLSON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598607492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068831315 | ||||||||
| FaxNumber: | 4068838910 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 13TH AVE E | ||||||||
| Address2: | ST. JOSEPH MEDICAL CENTER | ||||||||
| City: | POLSON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598605315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068835680 | ||||||||
| FaxNumber: | 4068838910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 12406 | MT | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.