Basic Information
| Provider Information | |||||||||
| NPI: | 1508032814 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KEN L JONAS M D P C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3031 | ||||||||
| Address2: | |||||||||
| City: | KALISPELL | ||||||||
| State: | MT | ||||||||
| PostalCode: | 599033031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067552823 | ||||||||
| FaxNumber: | 4062574820 | ||||||||
| Practice Location | |||||||||
| Address1: | 350 HERITAGE WAY STE 100 | ||||||||
| Address2: | |||||||||
| City: | KALISPELL | ||||||||
| State: | MT | ||||||||
| PostalCode: | 599013159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062572384 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 06/03/2008 | ||||||||
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| AuthorizedOfficialLastName: | JONAS | ||||||||
| AuthorizedOfficialFirstName: | KEN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4062572384 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 9787 | MT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.