Main, Jonathan D
Main, Jonathan D is an individual health care provider with primary practice located at 7401 104Th Ave Suite 110, Kenosha WI 53142-7845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Main, Jonathan D can be contacted via phone (262) 764-5595.Contact Information
Primary practice address
7401 104Th Ave Suite 110
Kenosha WI 53142-7845
Phone: (262) 764-5595
Fax: (262) 764-9314
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 38865 | Wisconsin |
Profile Details
| NPI number | 1235110255 |
|---|---|
| LBN Legal business name | Main, Jonathan D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2005 |
| Last updated | Sep 19th, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235110255 | NPPES |
| Wisconsin | MEDICAID | 32337800 |
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