Physician Assistant, Surgical
MITCHELL HALL PAC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1164194593 · enumerated 2021-10-04 · record updated 2025-12-09. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 500 W BROADWAY ST FL 5, MISSOULA, MT, 59802-4096 (406) 329-5866 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 31001, PASADENA, CA, 91110-4110 (406) 329-5866 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant, Surgical 363AS0400X · Primary · License MED-PAC-LIC-131239 MT
- Physician Assistant, Surgical 363AS0400X · License PT956 WY
In this directory
Locations and evidence
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Practice location
MISSOULA, MT, 598024096
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.