Provider Demographics
NPI:1275534141
Name:MEISSNER, DAVID S (PA C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:MEISSNER
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 1:16 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59645-9036
Mailing Address - Country:US
Mailing Address - Phone:406-547-3321
Mailing Address - Fax:406-547-3298
Practice Address - Street 1:16 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59645-9036
Practice Address - Country:US
Practice Address - Phone:406-547-3321
Practice Address - Fax:406-547-3298
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT257363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0436798Medicaid
MT0436798Medicaid