Provider Demographics
NPI:1548488265
Name:FAMILY PRACTICE ASSOCIATES PC
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-587-3133
Mailing Address - Street 1:935 HIGHLAND BLVD
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6904
Mailing Address - Country:US
Mailing Address - Phone:406-587-3133
Mailing Address - Fax:406-596-9671
Practice Address - Street 1:935 HIGHLAND BLVD
Practice Address - Street 2:SUITE 2210
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6904
Practice Address - Country:US
Practice Address - Phone:406-587-3133
Practice Address - Fax:406-596-9671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT9986276Medicaid
C01394OtherRR MEDICARE
MT0404320001OtherDMERC
MT9986276Medicaid