Aaron J. Derry PAC
Physician Assistant in Missoula, MT(View on Map)
Full Name
Aaron J Derry PAC
NPI Number
1093755886
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/08/2006
Specialties
(Taxonomies)Code
363A00000X
363AM0700X
363AS0400X
Primary Taxonomy
Yes
No
No
Licenses
State
Montana
Montana
License Number
MED-PAC-LIC-402
402
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 12
500 WEST BROADWAY
City
Liberty Lake
Missoula
State
WA
MT
Postal Code
99019-0012
59802-4008
Country
US
US
Telephone Number
(406) 543-7271
(406) 721-5600
Identifiers
Identifier
4304287
Identifier State
MT
Identifier Issuer
Unknown
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
aderry135851@wm.providencedirect.org
Endpoint Description
Unknown
Use
Direct
Content Type
Unknown
Affiliation
N
Endpoint Location
500 West BroadwayMissoula, MT598024008US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/24/2021
Provider Address
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