Individual
JACKSON A SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 WESTWOOD DR, HAMILTON, MT 59840-2345
(406) 363-2211
Mailing address
1200 WESTWOOD DR, HAMILTON, MT 59840-2345
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
9661578
ID
207P00000X
Emergency Medicine Physician
Primary
MED-PHYS-LIC-118840
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669008710
—
ID
05
—
200016364
—
MT
Enumeration date
03/20/2020
Last updated
01/29/2025
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