Provider Demographics
NPI:1821720608
Name:MCGLINCHEY, CHASE ALEXANDER (PA)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:ALEXANDER
Last Name:MCGLINCHEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1518 CHOUTEAU ST
Mailing Address - Street 2:
Mailing Address - City:FORT BENTON
Mailing Address - State:MT
Mailing Address - Zip Code:59442-9003
Mailing Address - Country:US
Mailing Address - Phone:406-622-5485
Mailing Address - Fax:406-622-5670
Practice Address - Street 1:1518 CHOUTEAU ST
Practice Address - Street 2:
Practice Address - City:FORT BENTON
Practice Address - State:MT
Practice Address - Zip Code:59442-9003
Practice Address - Country:US
Practice Address - Phone:406-622-5485
Practice Address - Fax:406-622-5670
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
MT117315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant