Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | MT4842 | MT |
NPI | 1003919853 |
---|---|
Provider Name | Brian L Priest |
First Address | Lewistown, MT 59457-8755 |
Second Address | Lewistown, MT 59457-2261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 01/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000092530 | BCBS (01) | MT |
0355771 | (05) | MT |
237169043594579001 | TRICARE (01) | MT |
D96264 | (02) | MT |