Basic Information
Provider Information
NPI: 1174103063
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FURCHNER
FirstName: AARON
MiddleName: ROBERT
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2800 10TH AVE N
Address2:  
City: BILLINGS
State: MT
PostalCode: 591010799
CountryCode: US
TelephoneNumber: 4062382500
FaxNumber:  
Practice Location
Address1: 2800 10TH AVE N
Address2:  
City: BILLINGS
State: MT
PostalCode: 591010799
CountryCode: US
TelephoneNumber: 4062382500
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2021
LastUpdateDate: 02/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMED-PAC-LIC-91639MTY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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