Moulton, Jonathan V

Moulton, Jonathan V is an individual health care provider with primary practice located at 2414 Kohler Memorial Dr , Sheboygan WI 53081. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Moulton, Jonathan V can be contacted via phone (920) 457-4461.

Contact Information

Primary practice address
2414 Kohler Memorial Dr Sheboygan WI 53081
Fax: (920) 459-1178
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20220 Wisconsin

Profile Details

NPI number 1851408264
LBN Legal business name Moulton, Jonathan V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Mar 7th, 2023 - about 2 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 1851408264 NPPES
Wisconsin MEDICAID 31195500

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