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NPI Code Detail

MEDICARE: DR. DOUGLAS CORNELIUS M.D.

MEDICARE: DR. DOUGLAS CORNELIUS 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
1207L00000XAnesthesiology Physician8803MT

General Provider Information

NPI Number : 1588631204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS CORNELIUS M.D.
Provider Business Mailing Address
First Line : PO BOX 1261
Second Line :
City : BILLINGS
State : MT
Zip : 59103-1261
Country : US
Telephone Number : 406-254-0707
Fax Number : 406-254-0709
Provider Business Practice Location Address
First Line : 1233 N 30TH ST
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0127
Country : US
Telephone Number : 406-254-0707
Fax Number : 406-254-0709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 07/08/2010

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