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Individual

MR. RONALD SHEARER GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
(406) 883-8910
Mailing address
PO BOX 1010, POLSON, MT 59860-1010
(406) 883-5680
(406) 883-8910

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12233
MT
208600000X
Surgery Physician
5117A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107193900
WY
01
5117A
PHYSICIAN LICENSE
WY
Enumeration date
07/14/2006
Last updated
07/17/2013
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