Individual
JON EVAN ROSENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1232 N 15TH AVE STE 2, BOZEMAN, MT 59715-3299
(406) 518-1598
(406) 587-7742
Mailing address
1232 N 15TH AVE STE 2, BOZEMAN, MT 59715-3299
(406) 518-1598
(406) 587-7742
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
34594
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180501207
—
TX
05
—
180501208
—
TX
05
—
180501209
—
TX
05
—
180501210
—
TX
05
—
180501221
—
TX
Enumeration date
05/12/2006
Last updated
10/09/2023
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