Basic Information
| Provider Information | |||||||||
| NPI: | 1356728711 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HURLBUT | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | ELISE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1224 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598402338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063754824 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1200 WESTWOOD DR | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598402345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063632211 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2015 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 007624 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 77130 | MT | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 77130 | MT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.