1. Home
  2. Directory
  3. Montana
  4. Bozeman
  5. Dermatology
  6. NPI Profile
  7. NPI Record 1811345093

MOLLY BUCKLAND D.O.
Complete NPI Record 1811345093
Dermatology - MOHS-Micrographic Surgery in Bozeman, MT

NPI Status: Active since May 29, 2016

Contact Information

1905 W COLLEGE ST
BOZEMAN, MT
ZIP 59718
Phone: (406) 587-4432
Fax: (406) 587-7015

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Credential Text
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Provider License Number 1
  24. Provider License Number State Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Healthcare Provider Taxonomy Code 2
  27. Provider License Number 2
  28. Provider License Number State Code 2
  29. Healthcare Provider Primary Taxonomy Switch 2
  30. Healthcare Provider Taxonomy Code 3
  31. Provider License Number 3
  32. Provider License Number State Code 3
  33. Healthcare Provider Primary Taxonomy Switch 3
  34. Is Sole Proprietor
  35. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1811345093. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1811345093
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Entity Type Code: 1
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Name: MOLLY
The city name in the location address of the provider being identified.
Provider Credential Text: D.O.
The State code in the location of the provider being identified.
Provider First Line Business Mailing Address: 1905 W COLLEGE ST
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address City Name: BOZEMAN
The country code in the location address of the provider being identified.
Provider Business Mailing Address State Name: MT
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 597184061
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Country Code If outside U S : US
The date that a record was last updated or changed.
Provider Business Mailing Address Telephone Number: 4065874432
The code designating the provider’s gender if the provider is a person.
Provider First Line Business Practice Location Address: 1905 W COLLEGE ST
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address City Name: BOZEMAN
Provider Business Practice Location Address State Name: MT
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider Business Practice Location Address Postal Code: 597184061
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4065874432
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 4065877015
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/29/2016
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 12/1/2021
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207N00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 5101023390
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: MI
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 208D00000X
Provider License Number 2: UO4915
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: FL
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 207ND0101X
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider License Number 3: 91884
The last name of the provider. If the provider is an individual, this is the legal name.
Provider License Number State Code 3: MT
The first name of the provider, if the provider is an individual.
Healthcare Provider Primary Taxonomy Switch 3: Y
The middle name of the provider, if the provider is an individual.
Is Sole Proprietor: N
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
NPI Certification Date: 12/1/2021
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.