Deitch, Jonathan S.

Deitch, Jonathan S. is an individual health care provider with primary practice located at 1325 Pennsylvania Ave Ste 680 , Fort Worth TX 76104-2133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Deitch, Jonathan S. can be contacted via phone (817) 250-4235.

Contact Information

Primary practice address
1325 Pennsylvania Ave Ste 680 Fort Worth TX 76104-2133
Phone: (817) 250-4235
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 194966-1 New York
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X T3610 Texas

Profile Details

NPI number 1679551469
LBN Legal business name Deitch, Jonathan S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Oct 20th, 2021 - about 3 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 1679551469 NPPES
New York MEDICAID 01921764

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