Individual
ADAM R MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1027 N 27TH ST, BILLINGS, MT 59101-0711
(406) 237-8855
Mailing address
1027 N 27TH ST, BILLINGS, MT 59101-0711
(406) 237-8855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
356
WY
363A00000X
Physician Assistant
Primary
508
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000900383
BCBS PIN
MT
05
—
102405100
—
WY
01
—
315012
BCBS
WY
01
—
612315900
OWCP
WY
Enumeration date
09/26/2006
Last updated
09/26/2016
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