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NPI Code Detail

MEDICARE: ROBERT H ANDERSON PA C

MEDICARE: ROBERT H ANDERSON PA C
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
1363AM0700XMedical Physician AssistantPA-289ID
2363A00000XPhysician Assistant155263MT

General Provider Information

NPI Number : 1700841277
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT H ANDERSON PA C
Provider Business Mailing Address
First Line : PO BOX 5096
Second Line :
City : GREAT FALLS
State : MT
Zip : 59403-5096
Country : US
Telephone Number : 406-622-5485
Fax Number :
Provider Business Practice Location Address
First Line : 1518 CHOUTEAU ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-9003
Country : US
Telephone Number : 406-622-5485
Fax Number : 406-622-5670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 05/07/2025

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