Provider Demographics
NPI:1487752655
Name:HETHERINGTON, HUGH ELLIOTT (MD)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:ELLIOTT
Last Name:HETHERINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2047 N LAST CHANCE GULCH STE 369
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0744
Mailing Address - Country:US
Mailing Address - Phone:406-581-5328
Mailing Address - Fax:406-289-9606
Practice Address - Street 1:925 HIGHLAND BLVD STE 1160
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6905
Practice Address - Country:US
Practice Address - Phone:406-414-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6361207YS0123X, 207YX0602X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT101847Medicaid
MTF65007Medicare UPIN
MT101847Medicaid