Provider Demographics
NPI:1033154760
Name:SHENTON, DAVID W JR (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:SHENTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 140W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7507
Mailing Address - Country:US
Mailing Address - Phone:406-237-5050
Mailing Address - Fax:406-238-6599
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:#100E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6700
Practice Address - Fax:406-238-6734
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6941207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000002231OtherBLUE CROSS
MT0090727Medicaid
MT000002231OtherBLUE CROSS
MT0090727Medicaid
MT000008429Medicare PIN
MT010000223Medicare PIN