Provider Demographics
NPI:1518455781
Name:LESTER, ANDREW CLARK (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CLARK
Last Name:LESTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 J BAR LOOP
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MT
Mailing Address - Zip Code:59644-8502
Mailing Address - Country:US
Mailing Address - Phone:406-781-9827
Mailing Address - Fax:
Practice Address - Street 1:3687 VETERANS DR
Practice Address - Street 2:
Practice Address - City:FORT HARRISON
Practice Address - State:MT
Practice Address - Zip Code:59636-9700
Practice Address - Country:US
Practice Address - Phone:406-442-6410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-RES-LIC-67439390200000X
MTMED-PHYS-LIC-96968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program