Healthcare Provider Details

I. General information

NPI: 1912126368
Provider Name (Legal Business Name): PAUL JOHN MURTER III PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date: 07/17/2007
Reactivation Date: 09/10/2008

III. Provider practice location address

1223 N CENTER AVE
HARDIN MT
59034-1100
US

IV. Provider business mailing address

1223 N CENTER AVE
HARDIN MT
59034-1100
US

V. Phone/Fax

Practice location:
  • Phone: 406-665-4103
  • Fax:
Mailing address:
  • Phone: 406-665-4103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number254MED-PAC-LIC-254
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: