Basic Information
| Provider Information | |||||||||
| NPI: | 1568482925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEITZ | ||||||||
| FirstName: | TRISTAN | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6369 | ||||||||
| Address2: | |||||||||
| City: | HELENA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 596046369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064472823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2475 E BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | HELENA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 596014928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064574180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 03/30/2018 | ||||||||
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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 | 207R00000X | 9881 | MT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 9881 | MT | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 9881 | 01 | MT | LICENSE | OTHER |