Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 9780 | MT |
NPI | 1760464275 |
---|---|
Provider Name | Jon F. Robinson |
First Address | Bozeman, MT 59715-8812 |
Second Address | Bozeman, MT 59715-8812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36142 | (05) | MT |
H37431 | (02) | MT |