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NPI Code Detail

MEDICARE: DR. VERN HICKS HORTON MD

MEDICARE:  DR. VERN HICKS HORTON  MD
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
1208600000XSurgery Physician3719MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073597639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VERN HICKS HORTON MD
Provider Business Mailing Address
First Line : 5750 COCHISE DR
Second Line :
City : MISSOULA
State : MT
Zip : 59804-9746
Country : US
Telephone Number : 406-251-2160
Fax Number : 406-251-2160
Provider Business Practice Location Address
First Line : 2827 FORT MISSOULA RD
Second Line : COMMUNITY MEDICAL CENTER
City : MISSOULA
State : MT
Zip : 59804-7408
Country : US
Telephone Number : 406-728-4100
Fax Number : 406-327-4502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 07/08/2007

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