NPI 1518464643 · live from the CMS NPI Registry
Jack Tower Branston, MD
Emergency Medicine in Missoula, MT. National Provider Identifier 1518464643, active.
NPI record
| NPI | 1518464643 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Emergency Medicine 207P00000X |
| Practice location | 500 W Broadway St, Missoula, MT 59802 |
| Practice phone | 406-329-5635 |
| Mailing address | Po Box 12, Liberty Lake, WA 99019 |
| Enumerated | April 5, 2018 |
| Last updated | November 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emergency Medicine | 207P00000X | 11420196-1205 (UT) |
| Emergency Medicine primary | 207P00000X | MED-PHYS-LIC-96286 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.