Provider Demographics
NPI:1619041704
Name:SCHMIDT, RODNEY JAMES (PA-C)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:JAMES
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2069
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-2069
Mailing Address - Country:US
Mailing Address - Phone:406-297-3145
Mailing Address - Fax:406-297-3364
Practice Address - Street 1:304 OSLOSKI RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9217
Practice Address - Country:US
Practice Address - Phone:406-297-3145
Practice Address - Fax:406-297-3364
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT482363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1057829OtherNCCPA
MT1619041704Medicaid
MT1619041704OtherBCBS
1057829OtherNCCPA