Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 77208 | MT |
N | 208600000X | Surgeon | 77208 | MT |
Y | 2086S0129X | Vascular Surgeon | 77208 | MT |
NPI | 1093081150 |
---|---|
Provider Name | Jason Richard Hurd |
First Address | Missoula, MT 59802-4096 |
Second Address | Missoula, MT 59802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2012 |
Last Update Date | 01/06/2021 |