Individual provider Active NPI

David Lee Wilson, M.D.

  • Anesthesiology Physician
  • Missoula, MT
National Provider Identifier
1447249404
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
8617 Issued in MT
Practice address
3550 Mullan Rd
Suite 103
Missoula, MT 59808-5168
Phone
(406) 728-8420
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 8617 MT Primary

Addresses

Primary practice location

3550 Mullan Rd
Suite 103
Missoula, MT 59808-5168

Mailing address

PO Box 17527
Missoula, MT 59808-7527
Phone (406) 728-8420

Other identifiers 1

IdentifierTypeStateIssuer
0050966MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000924 MT Practitioner - Anesthesiology 6608817606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Florida College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Bone and Joint LLCGroup PAC ID 3870583990, 57 clinicians

Practice addresses (Care Compare)

2360 Mullan Rd
Suite C
Missoula, MT 59808-1811
Phone (406) 721-4436

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8617MTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Anesthesiology, P.C. Anesthesiology CurrentSince Jan 1, 2003 Accepting new patients
Anesthesiology Consultants of Idaho PA Anesthesiology Past Accepting new patients
Ma Critical Care Services, PC Past Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

3550 Mullan Rd
Ste 103
Missoula, MT 59808

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2360 Mullan Rd
Missoula, MT 59808
Phone (406) 541-4263

2825 Stockyard Rd
Ste I-200
Missoula, MT 59808
Phone (406) 728-4100

902 N Orange St
Missoula, MT 59802
Phone (406) 327-3300

2360 Mullan Rd
Ste C
Missoula, MT 59808
Phone (406) 542-9695

2833 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 542-6559

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1447249404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17527",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598087527",
            "telephone_number": "406-728-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MULLAN RD",
            "address_2": "SUITE 103",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085168",
            "telephone_number": "406-728-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MT",
            "license": "8617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050966",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.