Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 6594 | MT |
NPI | 1417060328 |
---|---|
Provider Name | Dr. John William Mcmahon JR. |
First Address | Helena, MT 59601-4949 |
Second Address | Helena, MT 59601-4949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 13/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CN6268 | RAILROAD MEDICARE (01) | MT |
E11579 | (02) | MT |