Provider Demographics
NPI:1225046329
Name:FRANCES, JONATHAN E (DO)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:E
Last Name:FRANCES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 MEMORIAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-3154
Mailing Address - Country:US
Mailing Address - Phone:812-254-2400
Mailing Address - Fax:812-254-3191
Practice Address - Street 1:1401 MEMORIAL AVE STE B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-3154
Practice Address - Country:US
Practice Address - Phone:812-254-2400
Practice Address - Fax:812-254-3191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002470A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200375580AMedicaid
IN000000231202OtherBC/BS
IN200375580AMedicaid
IN265260AMedicare PIN
IN000000231202OtherBC/BS