Basic Information
Provider Information | |||||||||
NPI: | 1326030172 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCDOWELL | ||||||||
FirstName: | GREGORY | ||||||||
MiddleName: | S | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2900 12TH AVE N | ||||||||
Address2: | SUITE 140W | ||||||||
City: | BILLINGS | ||||||||
State: | MT | ||||||||
PostalCode: | 591017506 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4062386540 | ||||||||
FaxNumber: | 4062386599 | ||||||||
Practice Location | |||||||||
Address1: | 2900 12TH AVE N | ||||||||
Address2: | SUITE 140W | ||||||||
City: | BILLINGS | ||||||||
State: | MT | ||||||||
PostalCode: | 591017506 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4062375050 | ||||||||
FaxNumber: | 4062386599 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/18/2005 | ||||||||
LastUpdateDate: | 05/10/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 05/10/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 7393 | MT | Y |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   |
ID Information
ID | Type | State | Issuer | Description | 200015689 | 01 | MT | RAILROAD MEDICARE | OTHER | 99697 | 05 | MT |   | MEDICAID | 000091758 | 01 | MT | BLUECROSS BLUESHIELD | OTHER |