Provider Demographics
NPI:1730547654
Name:PATON, MADELYN TAYLO
Entity type:Individual
Prefix:MS
First Name:MADELYN
Middle Name:TAYLO
Last Name:PATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2036
Mailing Address - Country:US
Mailing Address - Phone:406-403-6001
Mailing Address - Fax:
Practice Address - Street 1:407 7TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2036
Practice Address - Country:US
Practice Address - Phone:406-403-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7791171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor