Provider Demographics
NPI:1730274101
Name:PLASTIC AND RECONSTRUCTIVE SURGERY OF HELENA, P.C.
Entity type:Organization
Organization Name:PLASTIC AND RECONSTRUCTIVE SURGERY OF HELENA, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-443-8233
Mailing Address - Street 1:715 GETCHELL STREET
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601
Mailing Address - Country:US
Mailing Address - Phone:406-443-8233
Mailing Address - Fax:406-443-2480
Practice Address - Street 1:715 GETCHELL STREET
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-443-8233
Practice Address - Fax:406-443-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT174400000X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0108277Medicaid
MT4709OtherMONTANA MEDICAL LICENSE
MT4709OtherMONTANA MEDICAL LICENSE
MT0108277Medicaid