Healthcare Provider Details

I. General information

NPI: 1033724307
Provider Name (Legal Business Name): JEFFREY AUSTIN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2020
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WESTWOOD DR STE I
HAMILTON MT
59840-2345
US

IV. Provider business mailing address

1200 WESTWOOD DR
HAMILTON MT
59840-2345
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-1100
  • Fax: 406-375-4884
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMED-PAC-LIC-90413
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: