Staidle, Jonathan Patrick

Staidle, Jonathan Patrick is an individual health care provider with primary practice located at 4814 Sparks Blvd , Sparks NV 89436-8219. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Staidle, Jonathan Patrick can be contacted via phone (775) 327-0699.

Contact Information

Primary practice address
4814 Sparks Blvd Sparks NV 89436-8219
Phone: (775) 327-0699
Fax: (775) 451-7501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X MD457066 Pennsylvania
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 35-126612 Ohio

Profile Details

NPI number 1982994455
LBN Legal business name Staidle, Jonathan Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2011
Last updated Jan 19th, 2021 - 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 1982994455 NPPES
Ohio MEDICAID 0129749

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