Provider Demographics
NPI:1326199035
Name:GRIER, JONATHAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:F
Last Name:GRIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 9TH AVE
Mailing Address - Street 2:SUITE 2 A
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2014
Mailing Address - Country:US
Mailing Address - Phone:814-941-7170
Mailing Address - Fax:814-941-7427
Practice Address - Street 1:2525 9TH AVE
Practice Address - Street 2:SUITE 2 A
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2014
Practice Address - Country:US
Practice Address - Phone:814-941-7170
Practice Address - Fax:814-941-7427
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056197L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015387340004Medicaid
PAF71359Medicare UPIN
PA786137Medicare PIN