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NPI Code Detail

MEDICARE: BETH C ROBITAILLE MD

MEDICARE: BETH C ROBITAILLE 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
1207Q00000XFamily Medicine Physician6208AWY

Other Identifiers

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

General Provider Information

NPI Number : 1396788865
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH C ROBITAILLE MD
Provider Business Mailing Address
First Line : 1522 E A ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2217
Country : US
Telephone Number : 307-234-6161
Fax Number : 307-234-7033
Provider Business Practice Location Address
First Line : 1522 E A ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2217
Country : US
Telephone Number : 307-234-6161
Fax Number : 307-234-7033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 07/17/2023

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Directions to “ BETH C ROBITAILLE MD” Practice Location

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