Taverna, Jacob Michael
Taverna, Jacob Michael is an individual health care provider with primary practice located at 435 S Crystal St Suite 300, Butte MT 59701-1506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Taverna, Jacob Michael can be contacted via phone (406) 496-3600.Contact Information
Primary practice address
435 S Crystal St Suite 300
Butte MT 59701-1506
Phone: (406) 496-3600
Fax: (406) 496-3653
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 7657 | Montana |
Profile Details
| NPI number | 1811979099 |
|---|---|
| LBN Legal business name | Taverna, Jacob Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Jan 21st, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811979099 | NPPES |
| Montana | MEDICAID | 006 4818 |
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