=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528096146
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOEY MICHELE BANKS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2006
-----------------------------------------------------
Last Update Date | 03/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 HICKORY ST STE 4
-----------------------------------------------------
City | MISSOULA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59801-1896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-541-2012
-----------------------------------------------------
Fax | 406-296-4320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 HICKORY ST STE 4
-----------------------------------------------------
City | MISSOULA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59801-1896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-541-2012
-----------------------------------------------------
Fax | 406-296-4320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 12588
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 161340
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 0903
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------