Basic Information
| Provider Information | |||||||||
| NPI: | 1538241849 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUFFEL | ||||||||
| FirstName: | BETTY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 HOSPITAL WAY | ||||||||
| Address2: | |||||||||
| City: | WHITEFISH | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068633500 | ||||||||
| FaxNumber: | 4068627805 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 HOSPITAL WAY | ||||||||
| Address2: | |||||||||
| City: | WHITEFISH | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068633500 | ||||||||
| FaxNumber: | 4068627805 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 6033 | MT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0355628 | 05 | MT | MEDICAID |