Glen, Jonathan Coleman

Glen, Jonathan Coleman is an sole proprietor health care provider with primary practice located at 716 E 71St St , Savannah GA 31405-4907. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Glen, Jonathan Coleman can be contacted via phone (912) 355-1533.

Contact Information

Primary practice address
716 E 71St St Savannah GA 31405-4907
Fax: (912) 355-5984
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 21984 Georgia
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 7816 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 7816 South Carolina

Profile Details

NPI number 1407904493
LBN Legal business name Glen, Jonathan Coleman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 8th, 2007
Last updated Mar 11th, 2020 - about 5 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 1407904493 NPPES
Georgia MEDICAID 00234429A
Georgia MEDICAID G07186

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