Organization Name: | BENEFIS MEDICAL GROUP |
NPI Number: | 1043469513 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY W. SPEER (PRESIDENT) |
Mailing Address: | 1117 29th Street South Great Falls |
State: | MT US |
Postal Code: | 594055306 |
Phone Number: | 4064558150 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2008 |
NPI Last Update Date: | 11/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080P0207X |
License Number: | 10145 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Pediatric Hematology-Oncology |
Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |