Individual
TROY D WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 12TH AVE N, SUITE 140W, BILLINGS, MT 59101-7506
(406) 238-6540
(406) 238-6599
Mailing address
PO BOX 35100, BILLINGS, MT 59107-5100
(406) 238-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
442
MT
363AS0400X
Surgical Physician Assistant
Primary
MED-PAC-LIC-442
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000900323
BCBS PIN
MT
05
—
4307970
—
MT
Enumeration date
05/28/2006
Last updated
12/14/2021
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