Provider Demographics
NPI:1457731705
Name:NATHAN A SANDERS DO PC
Entity Type:Organization
Organization Name:NATHAN A SANDERS DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:406-465-7646
Mailing Address - Street 1:3116 SADDLE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8645
Mailing Address - Country:US
Mailing Address - Phone:406-431-3280
Mailing Address - Fax:406-502-1525
Practice Address - Street 1:3116 SADDLE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8645
Practice Address - Country:US
Practice Address - Phone:406-431-3280
Practice Address - Fax:406-502-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21215207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty