Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mitchell Glen Hall, PAC

Individual provider Surgical Physician Assistant · NPI 1164194593

Mitchell Glen Hall, PAC is a Physician Assistant in Missoula, Montana. Qualified in 2021, 5 years ago. Practices with Providence Health and Services Mt, a 358-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Montana and Wyoming.

Years since qualifying
5
Licensed in
MT, WY
In the registry since
2021
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

500 W Broadway St Fl 5
Missoula, MT 59802-4096
Phone: (406) 329-5866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6600 E 2nd St Ste A, Casper, WY 82609-4348 — (307) 333-4363

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence MED-PAC-LIC-131239 (MT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PT956 (WY)

Record details

NPI number1164194593
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 4, 2021
Last updated in NPPESDecember 9, 2025
Certification dateDecember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Providence Health And Services Mt — 358 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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