Basic Information
| Provider Information | |||||||||
| NPI: | 1174689640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEAGER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 SUNSET BLVD | ||||||||
| Address2: | |||||||||
| City: | CONRAD | ||||||||
| State: | MT | ||||||||
| PostalCode: | 594251717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062713231 | ||||||||
| FaxNumber: | 4062713576 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 COMMONS WAY | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | KALISPELL | ||||||||
| State: | MT | ||||||||
| PostalCode: | 599011915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067525170 | ||||||||
| FaxNumber: | 4067525210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 02/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 484 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 1074041 | 01 | NCCPA | OTHER | 1174689640 | 05 | MT | MEDICAID | 1174689640 | 01 | MT | BCBS | OTHER |