Provider Demographics
NPI:1891204988
Name:NEILL, DAVID MICHAEL (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:NEILL
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 1:2801 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3425
Mailing Address - Country:US
Mailing Address - Phone:406-490-0774
Mailing Address - Fax:
Practice Address - Street 1:310 SOUTH SANSOME ST.
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:MT
Practice Address - Zip Code:59858
Practice Address - Country:US
Practice Address - Phone:406-859-3271
Practice Address - Fax:406-859-3011
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical