Healthcare Provider Details

I. General information

NPI: 1891204988
Provider Name (Legal Business Name): DAVID MICHAEL NEILL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SOUTH SANSOME ST.
PHILIPSBURG MT
59858
US

IV. Provider business mailing address

2801 HILL AVE
BUTTE MT
59701-3425
US

V. Phone/Fax

Practice location:
  • Phone: 406-859-3271
  • Fax: 406-859-3011
Mailing address:
  • Phone: 406-490-0774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-60146
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMED-PAC-LIC-60146
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: