Provider Demographics
NPI:1154484798
Name:HONTANOSAS, JESUS C (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:C
Last Name:HONTANOSAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3000 HOSPITAL DR
Mailing Address - Street 2:STE 130
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1921
Mailing Address - Country:US
Mailing Address - Phone:513-732-1660
Mailing Address - Fax:513-732-1665
Practice Address - Street 1:2055 HOSPITAL DR
Practice Address - Street 2:SUITE 335
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-1978
Practice Address - Country:US
Practice Address - Phone:513-732-1660
Practice Address - Fax:513-732-1665
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.043368208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0405798Medicaid
A78939Medicare UPIN
OHHO0466703Medicare PIN