MEDICARE: DR. PAUL A EODICE D.O.

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	207Q00000X	Family Medicine Physician	9754	MT
2	208VP0014X	Interventional Pain Medicine Physician	9754	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
2	0098925	OTHER	MT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659351211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL A EODICE D.O.

Provider Business Mailing Address
First Line	:	2707 COLONIAL DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-4926
Country	:	US
Telephone Number	:	406-457-0800
Fax Number	:	406-457-0805

Provider Business Practice Location Address
First Line	:	2707 COLONIAL DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-4926
Country	:	US
Telephone Number	:	406-457-0800
Fax Number	:	406-457-0805

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. PAUL A EODICE D.O.” Practice Location

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