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NPI Code Detail

MEDICARE: PATRICIA E CANTRELL PAC

MEDICARE: PATRICIA E CANTRELL PAC
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
1363AS0400XSurgical Physician Assistant225MT

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 : 1386634491
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA E CANTRELL PAC
Provider Business Mailing Address
First Line : 214 14TH AVE SW
Second Line :
City : SIDNEY
State : MT
Zip : 59270-3521
Country : US
Telephone Number : 406-488-2380
Fax Number : 406-488-2382
Provider Business Practice Location Address
First Line : 214 14TH AVE SW
Second Line :
City : SIDNEY
State : MT
Zip : 59270-3521
Country : US
Telephone Number : 406-488-2380
Fax Number : 406-488-2382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 12/08/2020

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Directions to “ PATRICIA E CANTRELL PAC” Practice Location

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