Provider Demographics
NPI:1871672428
Name:JUDY L SCHMIDT, MD/PC
Entity Type:Organization
Organization Name:JUDY L SCHMIDT, MD/PC
Other - Org Name:GUARDIAN ONCOLGY AND CENTER FOR WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-721-1118
Mailing Address - Street 1:PO BOX 952274
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75395-0001
Mailing Address - Country:US
Mailing Address - Phone:406-721-1118
Mailing Address - Fax:406-728-4055
Practice Address - Street 1:2835 FORT MISSOULA RD.
Practice Address - Street 2:SUITE 301
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7424
Practice Address - Country:US
Practice Address - Phone:406-721-1118
Practice Address - Fax:406-728-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6372207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0092092Medicaid
0211990001Medicare NSC
MT000083978Medicare PIN
MT0092092Medicaid