MEDICARE: ROBERT W SMITH 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	MED-PHYS-LIC-21198	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	:	1891772174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W SMITH M.D.

Provider Business Mailing Address
First Line	:	1200 WESTWOOD DR
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 WESTWOOD DR STE I
Second Line	:
City	:	HAMILTON
State	:	MT
Zip	:	59840-2345
Country	:	US
Telephone Number	:	406-363-1100
Fax Number	:	406-375-4884

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	11/12/2024

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