Provider Demographics
NPI:1528108933
Name:MUSKETT, ALAN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:MUSKETT
Suffix:
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 1:2510 17TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-245-3238
Mailing Address - Fax:406-248-6814
Practice Address - Street 1:2510 17TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1736
Practice Address - Country:US
Practice Address - Phone:406-245-3238
Practice Address - Fax:406-248-6814
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT68952086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0145574Medicaid
WY103727700Medicaid
MT91366OtherBLUE CROSS BLUE SHIELD
MT0145574Medicaid
MT91366OtherBLUE CROSS BLUE SHIELD
MT000084774Medicare PIN