MEDICARE: JOHN R RIBIC DO

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	207RC0000X	Cardiovascular Disease Physician	34002534	OH
2	207RC0000X	Cardiovascular Disease Physician	OP60566232	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000352642	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073513743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R RIBIC DO

Provider Business Mailing Address
First Line	:	4119 FOX HOLLOW DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59602-6006
Country	:	US
Telephone Number	:	406-227-1155
Fax Number	:	406-227-1591

Provider Business Practice Location Address
First Line	:	4119 FOX HOLLOW DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59602-6006
Country	:	US
Telephone Number	:	406-227-1155
Fax Number	:	406-227-1591

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	02/16/2017

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