Provider Demographics
NPI:1053480772
Name:DRYNAN, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:DRYNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 ST ANN STREET
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-6347
Mailing Address - Country:US
Mailing Address - Phone:406-782-0794
Mailing Address - Fax:406-782-0794
Practice Address - Street 1:3015 ST ANN STREET
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-6347
Practice Address - Country:US
Practice Address - Phone:406-782-0794
Practice Address - Fax:406-782-0794
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT3635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT08270OtherBCBS OF MT
MT035191Medicaid
MT0827Medicare ID - Type Unspecified
MT08270OtherBCBS OF MT