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NPI Code Detail

MEDICARE: DR. NATHAN JAY MATLOCK PHARMD

MEDICARE: DR. NATHAN JAY MATLOCK PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835X0200XOncology PharmacistPHA-PHA-LIC-114218MT

General Provider Information

NPI Number : 1437084977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN JAY MATLOCK PHARMD
Provider Business Mailing Address
First Line : 908 HUNTERS WAY
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-6021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 915 HIGHLAND BLVD
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-6902
Country : US
Telephone Number : 406-414-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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