Individual
DR. JASON ALEX RICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
119 E MAIN ST, LEWISTOWN, MT 59457-1710
(406) 535-5488
(406) 535-3210
Mailing address
PO BOX 59, LEWISTOWN, MT 59457-0059
(406) 535-2020
(406) 535-3210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
789
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000084800
GROUP MEDICARE
MT
01
—
011000654
MEDICARE PTAN
MT
05
—
0484245
—
MT
01
—
1245217199
BILLING PROVIDER NPI
MT
01
—
25603
BLUE CROSS BLUE SHIELD
MT
Enumeration date
07/03/2007
Last updated
03/03/2023
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