MEDICARE: HARRY FELTON P.A.

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	363AM0700X	Medical Physician Assistant	83	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	91143	OTHER	MT	BCBX

General Provider Information

NPI Number	:	1073504874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY FELTON P.A.

Provider Business Mailing Address
First Line	:	310 WENDELL AVE
Second Line	:	#103
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-2267
Country	:	US
Telephone Number	:	406-535-1480
Fax Number	:	406-535-1481

Provider Business Practice Location Address
First Line	:	310 WENDELL AVE
Second Line	:	#103
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-2267
Country	:	US
Telephone Number	:	406-535-1480
Fax Number	:	406-535-1481

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/21/2009

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