Doctor Name: | ROBERT WILLIAM JONATH |
NPI Number: | 1003282328 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP-C |
License Number: | COA.17934-NP |
Business Practice Address: | 36000 Euclid Avenue Willoughby, OH - 44094 |
Business Phone Number: | 4409539600 |
Business Fax Number: | |
Mailing Address: | 11933 Madison Rd, HUNTSBURG |
State: | OH |
Postal Code: | 440469711 |
Phone Number: | 4409539600 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2015 |
NPI Last Update Date: | 06/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.17934-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |