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General NPI Number Information
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NPI Number | 1306814207
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Entity Type | Individual
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Provider Name | TANYA D JAGODZINSKI MD
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Gender | Female
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 3401 AVENUE E
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City | BILLINGS
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State | MT
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Zip | 59102-6561
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Country | US
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Telephone | 406-281-8700
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Fax | 608-833-6932
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Provider Business Mailing Address
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Address Line | 3401 AVENUE E
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City | BILLINGS
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State | MT
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Zip | 59102-6561
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Country | US
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Telephone | 406-281-8700
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Fax | 406-281-8758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 11511
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License Number State | MT
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