Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 6361 | MT |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 6361 | MT |
NPI | 1487752655 |
---|---|
Provider Name | Dr. Hugh Elliott Hetherington |
First Address | Bozeman, MT 59715-6900 |
Second Address | Bozeman, MT 59715-6905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 06/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101847 | (05) | MT |
F65007 | (02) | MT |