Provider Demographics
NPI:1508032814
Name:KEN L JONAS M D P C
Entity Type:Organization
Organization Name:KEN L JONAS M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-257-2384
Mailing Address - Street 1:PO BOX 3031
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-3031
Mailing Address - Country:US
Mailing Address - Phone:406-755-2823
Mailing Address - Fax:406-257-4820
Practice Address - Street 1:350 HERITAGE WAY STE 100
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3159
Practice Address - Country:US
Practice Address - Phone:406-257-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9787208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty