Charlette A Small

Individual provider Active NPI Family Medicine Physician · Absarokee, MT

NPI 1104522796 · NPPES record last updated Feb 6, 2023

Key facts

NPI
1104522796
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
212613 (MT)
Practice address
45 Cottonwood Way
Absarokee, MT 59001-6211
Phone
(406) 328-7448
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
212613MTMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 212613 MT Yes

Addresses

Primary practice location

45 Cottonwood Way
Absarokee, MT 59001-6211

Mailing address

45 Cottonwood Way
Absarokee, MT 59001-6211
Phone (406) 699-0042

Other providers in Absarokee, MT

All providers in Absarokee, MT · Family Medicine Physician in Montana

Sources for this page

Verify at the official NPI Registry.