Wash, Jonathan Gordon

Wash, Jonathan Gordon is an individual health care provider with primary practice located at 5100 Franklin Ave Suite C, Waco TX 76710-6922. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Wash, Jonathan Gordon can be contacted via phone (254) 741-1824.

Contact Information

Primary practice address
5100 Franklin Ave Suite C Waco TX 76710-6922
Phone: (254) 741-1824
Fax: (254) 754-2667
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 1750 Texas

Profile Details

NPI number 1003899972
LBN Legal business name Wash, Jonathan Gordon
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Aug 26th, 2015 - about 9 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 1003899972 NPPES
Texas MEDICAID 178106401

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