Provider Demographics
NPI:1174689640
Name:SEAGER, SCOTT PAUL (PA-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:PAUL
Last Name:SEAGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-1717
Mailing Address - Country:US
Mailing Address - Phone:406-271-3231
Mailing Address - Fax:406-271-3576
Practice Address - Street 1:200 COMMONS WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1915
Practice Address - Country:US
Practice Address - Phone:406-752-5170
Practice Address - Fax:406-752-5210
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT484363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1074041OtherNCCPA
MT1174689640Medicaid
MT1174689640OtherBCBS
1074041OtherNCCPA