Provider Demographics
NPI:1023124039
Name:DRYE, JOHN N (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:DRYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KRUGER RD
Mailing Address - Street 2:PO BOX 768
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-9506
Mailing Address - Country:US
Mailing Address - Phone:406-826-4816
Mailing Address - Fax:406-826-4898
Practice Address - Street 1:10 KRUGER RD
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859-9506
Practice Address - Country:US
Practice Address - Phone:406-826-4816
Practice Address - Fax:406-826-4898
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3275207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0109525Medicaid
MT000015291OtherBLUE CROSS/MONTANA
MT080143683OtherMEDICARE RAILROAD
MT0109525Medicaid
MTA07488Medicare UPIN