Provider Demographics
NPI:1205424116
Name:THON, AROK (PA-STUDENT)
Entity type:Individual
Prefix:
First Name:AROK
Middle Name:
Last Name:THON
Suffix:
Gender:M
Credentials:PA-STUDENT
Other - Prefix:
Other - First Name:AROK
Other - Middle Name:
Other - Last Name:THON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7375
Mailing Address - Country:US
Mailing Address - Phone:181-627-7825
Mailing Address - Fax:
Practice Address - Street 1:507 RIDGEWAY LN NE
Practice Address - Street 2:
Practice Address - City:PINE ISLAND
Practice Address - State:MN
Practice Address - Zip Code:55963-9759
Practice Address - Country:US
Practice Address - Phone:181-627-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1534363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant