MEDICARE: DR. RICHARD H EGGLESTON M.D.

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	207P00000X	Emergency Medicine Physician	8725	MT

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

General Provider Information

NPI Number	:	1154377232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD H EGGLESTON M.D.

Provider Business Mailing Address
First Line	:	1224 W MAIN ST
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 W MAIN ST
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2338
Country	:	US
Telephone Number	:	406-363-0597
Fax Number	:	406-375-4858

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/08/2007

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