Provider Demographics
NPI:1134108277
Name:LIMPERT, JONATHAN N (M D)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:N
Last Name:LIMPERT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 E 5TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-3135
Mailing Address - Country:US
Mailing Address - Phone:636-861-7870
Mailing Address - Fax:636-861-7899
Practice Address - Street 1:851 E 5TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3135
Practice Address - Country:US
Practice Address - Phone:636-861-7870
Practice Address - Fax:636-861-7899
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003009024208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00134872OtherRAILROAD MEDICARE
MO209127901Medicaid
MO7152606OtherAETNA
MO671113OtherHEALTHLINK
MOP00134872OtherRAILROAD MEDICARE
MO209127901Medicaid