Individual
DAVID K. CUSTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-3636
(307) 688-7920
Mailing address
PO BOX 3011, GILLETTE, WY 82717-3011
(307) 688-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0123
SD
363A00000X
Physician Assistant
Primary
PA832
WY
Other
Enumeration date
04/10/2006
Last updated
07/29/2026
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