Thackeray, Jonathan David

Thackeray, Jonathan David is an individual health care provider with primary practice located at 1 Childrens Plz , Dayton OH 45404-1815. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child Abuse Pediatrics. Allopathic & Osteopathic Physicians / Child Abuse Pediatrics is his primary health care specialty. Thackeray, Jonathan David can be contacted via phone (937) 641-4000.

Contact Information

Primary practice address
1 Childrens Plz Dayton OH 45404-1815
Phone: (937) 641-4000
Fax: (937) 641-3918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.083628 Ohio
Allopathic & Osteopathic Physicians / Child Abuse Pediatrics 2080C0008X 35.083628 Ohio

Profile Details

NPI number 1437151453
LBN Legal business name Thackeray, Jonathan David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Oct 12th, 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 1437151453 NPPES
Ohio MEDICAID 2545026

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