Nicholson, Jonathon K

Nicholson, Jonathon K is an individual health care provider with primary practice located at 1400 E 2Nd St Ste 100 , Defiance OH 43512-9905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Nicholson, Jonathon K can be contacted via phone (419) 783-3226.

Contact Information

Primary practice address
1400 E 2Nd St Ste 100 Defiance OH 43512-9905
Phone: (419) 783-3226
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X 35080078 Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301104162 Michigan

Profile Details

NPI number 1538167572
LBN Legal business name Nicholson, Jonathon K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Feb 28th, 2023 - about last year

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 1538167572 NPPES
Ohio MEDICAID 0010639

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