1265507982 NPI number — DR. CHRISTINE LOUISE CAMERON D.C.

Table of content: DR. CHRISTINE LOUISE CAMERON D.C. (NPI 1265507982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265507982 NPI number — DR. CHRISTINE LOUISE CAMERON D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMERON
Provider First Name:
CHRISTINE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOSKETT
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1265507982
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2419 W MAIN ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
BOZEMAN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59718-3812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-586-3556
Provider Business Mailing Address Fax Number:
406-586-9332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2419 W MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
BOZEMAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59718-3812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-586-3556
Provider Business Practice Location Address Fax Number:
406-586-9332
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1213 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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