Healthcare Provider Details

I. General information

NPI: 1770835340
Provider Name (Legal Business Name): ABBEY M BARNHART PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 NORTH LINCOLN AVE
BROADUS MT
59317-0489
US

IV. Provider business mailing address

P.O.BOX 489
BROADUS MT
59317-0489
US

V. Phone/Fax

Practice location:
  • Phone: 406-436-2651
  • Fax: 406-436-2652
Mailing address:
  • Phone: 406-436-2651
  • Fax: 406-436-2652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-20114
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number20114
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: