Healthcare Provider Details

I. General information

NPI: 1326981358
Provider Name (Legal Business Name): NICHOLAS ARTHUR MATHIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 11TH AVE S STE 24
GREAT FALLS MT
59405-5263
US

IV. Provider business mailing address

1101 26TH ST S
GREAT FALLS MT
59405-5161
US

V. Phone/Fax

Practice location:
  • Phone: 406-771-6300
  • Fax: 406-731-8318
Mailing address:
  • Phone: 406-455-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMED-RES-LIC-173501
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: