IndividualActive
John Waller, MD
NPI 1598873440 · General Practice Physician · Bozeman, MT
Provider details
- NPI number
- 1598873440
- Entity type
- Individual
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 50236 (MT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
206 Westlake Park Blvd
Bozeman, MT 59718-8081
Phone: (843) 743-9667
Approximate (ZIP-level) locationGet directions
Mailing address
206 Westlake Park Blvd
Bozeman, MT 59718-8081
Registry dates
- Enumerated
- 2006-08-29
- Last updated
- 2024-10-17
- Certified
- 2024-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.