Supak, Allan R

Supak, Allan R is an individual health care provider with primary practice located at 320 Alpenglow Lane , Livingston MT 59047. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Supak, Allan R can be contacted via phone (406) 823-6414.

Contact Information

Primary practice address
320 Alpenglow Lane Livingston MT 59047
Phone: (406) 823-6414
Fax: (406) 823-6287
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 8521 Montana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 8521 Montana

Profile Details

NPI number 1649388497
LBN Legal business name Supak, Allan R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Dec 9th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649388497 NPPES
Montana MEDICAID 0014110
Montana Other 000018171

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