Provider Demographics
NPI:1912126368
Name:MURTER, PAUL JOHN III (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JOHN
Last Name:MURTER
Suffix:III
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 4TH ST W
Mailing Address - Street 2:B
Mailing Address - City:HARDIN
Mailing Address - State:MT
Mailing Address - Zip Code:59034-1802
Mailing Address - Country:US
Mailing Address - Phone:406-665-4103
Mailing Address - Fax:
Practice Address - Street 1:10 4TH ST W
Practice Address - Street 2:B
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-1802
Practice Address - Country:US
Practice Address - Phone:406-665-4103
Practice Address - Fax:406-000-0000
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-09-06
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-09-10
Provider Licenses
StateLicense IDTaxonomies
MT254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255617130OtherNPI