MEDICARE: DANNY MITCHELL HARBOUR M.D.

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	207Q00000X	Family Medicine Physician	5280	MT

General Provider Information

NPI Number	:	1235248584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNY MITCHELL HARBOUR M.D.

Provider Business Mailing Address
First Line	:	2160 FOREST GROVE RD
Second Line	:
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-8831
Country	:	US
Telephone Number	:	406-538-2912
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 WENDELL AVE
Second Line	:
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-2267
Country	:	US
Telephone Number	:	406-538-7711
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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