Provider Demographics
NPI:1023146040
Name:STRATFORD, WILLIAM D JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:STRATFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2831 FORT MISSOULA ROAD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804
Mailing Address - Country:US
Mailing Address - Phone:406-327-4075
Mailing Address - Fax:406-327-4559
Practice Address - Street 1:2831 FORT MISSOULA ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-327-4075
Practice Address - Fax:406-327-4559
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT38272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
09760OtherBCBS OF MT