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Individual

PAUL ANDREW PUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2360 MULLAN RD, SUITE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Mailing address
2360 MULLAN RD, SUITE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053

Taxonomy

Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
8250
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017051
MT
Enumeration date
01/10/2006
Last updated
12/12/2019
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