Basic Information
| Provider Information | |||||||||
| NPI: | 1306814207 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAGODZINSKI | ||||||||
| FirstName: | TANYA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3401 AVENUE E | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591026561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062818700 | ||||||||
| FaxNumber: | 4062818758 | ||||||||
| Practice Location | |||||||||
| Address1: | 3401 AVENUE E | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591026561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062818700 | ||||||||
| FaxNumber: | 6088336932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 11511 | MT | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.