Provider Demographics
NPI:1124118468
Name:DAMSCHEN, DONALD D (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:D
Last Name:DAMSCHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-1310
Mailing Address - Country:US
Mailing Address - Phone:406-826-4853
Mailing Address - Fax:
Practice Address - Street 1:CLARK FORK VALLEY HOSPITAL
Practice Address - Street 2:#10 KRUGER RD
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859
Practice Address - Country:US
Practice Address - Phone:406-826-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7969208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0072182Medicaid
MT83691Medicare ID - Type UnspecifiedMONTANA MEDICAID
MT0072182Medicaid