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Individual

DOUGLAS A. WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2825 8TH AVE N, BILLINGS, MT 59101-0909
(406) 238-2500
Mailing address
PO BOX 35100, BILLINGS, MT 59107-5100
(406) 238-2500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
353
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000095313
BCBS PIN
MT
01
119700200
MDCD PIN
WY
01
4302311
MDCD PIN
MT
Enumeration date
09/13/2006
Last updated
05/19/2008
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