Individual
MR. DAVID EZRA NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
312 FAIR GROUNDS ROAD, HAMILTON, MT 59840
(406) 361-7680
(406) 363-4060
Mailing address
312 FAIR GROUNDS ROAD, HAMILTON, MT 59840
(406) 361-7680
(406) 363-4060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0292
MT
363AM0700X
Medical Physician Assistant
0292
MT
363AS0400X
Surgical Physician Assistant
0292
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4310345
—
MT
Enumeration date
08/18/2005
Last updated
06/25/2013
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