Provider Demographics
NPI:1083823520
Name:AUSTIN, JENNIFER D (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:401 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1931
Mailing Address - Country:US
Mailing Address - Phone:406-563-8500
Mailing Address - Fax:406-563-8694
Practice Address - Street 1:305 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711
Practice Address - Country:US
Practice Address - Phone:406-563-8686
Practice Address - Fax:406-563-8691
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT12463207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1083823520OtherNPI