Basic Information
| Provider Information | |||||||||
| NPI: | 1881718666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRICKEY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | NATHANIEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1233 N 30TH ST | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591010127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062374116 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1233 N 30TH ST | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591010127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062374116 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 12/16/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101241215 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 18754 | MT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.