MEDICARE: DR. SUSAN ANN ASKIN 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	207R00000X	Internal Medicine Physician	7965	MT

General Provider Information

NPI Number	:	1588771604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN ANN ASKIN MD

Provider Business Mailing Address
First Line	:	21 BITTERROOT MOUNTAIN RD
Second Line	:
City	:	CLANCY
State	:	MT
Zip	:	59634-9631
Country	:	US
Telephone Number	:	406-442-3431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 WILLIAMS ST
Second Line	:
City	:	FORT HARRISON
State	:	MT
Zip	:	59636
Country	:	US
Telephone Number	:	406-447-7476
Fax Number	:

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/08/2007

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