MEDICARE: ROBERT KNUTSON P.C.

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	152W00000X	Optometrist	547	MT

Other Identifiers

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

General Provider Information

NPI Number	:	1669665527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT KNUTSON P.C.

Provider Business Mailing Address
First Line	:	1655 SHILOH RD
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-1726
Country	:	US
Telephone Number	:	406-651-9200
Fax Number	:	406-651-5553

Provider Business Practice Location Address
First Line	:	1655 SHILOH RD
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-1726
Country	:	US
Telephone Number	:	406-651-9200
Fax Number	:	406-651-5553

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT KNUTSON
Credential	:	O.D.
Telephone Number	:	406-651-9200

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	02/20/2008

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