Provider Demographics
NPI:1386290625
Name:DAY, DOUGLAS R (PA-C)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:DAY
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:1333 SURGICAL SERVICES WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4844
Mailing Address - Country:US
Mailing Address - Phone:406-751-5392
Mailing Address - Fax:406-751-0080
Practice Address - Street 1:1333 SURGICAL SERVICES WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4844
Practice Address - Country:US
Practice Address - Phone:406-751-5392
Practice Address - Fax:406-751-5406
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2024-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-112167363AM0700X
IN10002727A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical