MEDICARE: DR. WILLIAM CARL ANDERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	4811	MT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080179702	OTHER	MT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000017060	OTHER	MT	BCBS OF MT

General Provider Information

NPI Number	:	1083698740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CARL ANDERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 410
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-0410
Country	:	US
Telephone Number	:	406-346-2916
Fax Number	:	406-346-7478

Provider Business Practice Location Address
First Line	:	281 N. 17TH AVENUE
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-0410
Country	:	US
Telephone Number	:	406-346-2916
Fax Number	:	406-346-7478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	03/18/2010

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Directions to “ DR. WILLIAM CARL ANDERSON MD” Practice Location

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