Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 40951 | MT |
NPI | 1043282700 |
---|---|
Provider Name | Dr. David Young Healy JR. |
First Address | Kalispell, MT 59901-3105 |
Second Address | Kalispell, MT 59901-3105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 23/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043282700 | (05) | MT |