Provider Demographics
NPI:1871737965
Name:NICHOLAS J OKON DO PC
Entity type:Organization
Organization Name:NICHOLAS J OKON DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:OKON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:406-237-5545
Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:SUITE 202E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-237-5545
Mailing Address - Fax:406-237-5550
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 202E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-237-5545
Practice Address - Fax:406-237-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT83982084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000081959Medicare PIN
MTG80782Medicare UPIN