Healthcare Provider Details

I. General information

NPI: 1275534141
Provider Name (Legal Business Name): DAVID S MEISSNER PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W MAIN ST
WHITE SULPHUR SPRINGS MT
59645-9036
US

IV. Provider business mailing address

16 W MAIN ST
WHITE SULPHUR SPRINGS MT
59645-9036
US

V. Phone/Fax

Practice location:
  • Phone: 406-547-3321
  • Fax: 406-547-3298
Mailing address:
  • Phone: 406-547-3321
  • Fax: 406-547-3298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number257
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: