Healthcare Provider Details

I. General information

NPI: 1316193048
Provider Name (Legal Business Name): PEDIATRICS PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 S MONTANA ST
BUTTE MT
59701-2836
US

IV. Provider business mailing address

834 S MONTANA ST
BUTTE MT
59701-2836
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-0123
  • Fax: 406-723-0211
Mailing address:
  • Phone: 406-723-0123
  • Fax: 406-723-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JILL D ROBISON
Title or Position: OWNER/PROVIDER
Credential: M.D.
Phone: 406-723-0123