TYLER WAGSTAFF
Physician Assistant
Active
Individual
NPI: 1205266053
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant - Surgical | 363AS0400X | No | PA1227 (ID) |
| Physician Assistant | 363A00000X | Yes | MED-PAC-LIC-79860 (MT) |
Frequently Asked Questions
NPI 1205266053 is the National Provider Identifier for TYLER WAGSTAFF, a Physician Assistant provider located in Kalispell, MT. This NPI was enumerated on November 14, 2013.
TYLER WAGSTAFF practices at 160 HERITAGE WAY STE 202, Kalispell, MT 59901.
Quick Facts
- NPI
- 1205266053
- Type
- Individual
- Enumerated
- Nov 14, 2013
- Last Updated
- May 31, 2023
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