Provider Demographics
NPI:1417147141
Name:KONTI, JON A (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:A
Last Name:KONTI
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 1:3200 S COUNTRY CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4054
Mailing Address - Country:US
Mailing Address - Phone:480-839-0206
Mailing Address - Fax:480-839-0208
Practice Address - Street 1:3200 S COUNTRY CLUB WAY
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4054
Practice Address - Country:US
Practice Address - Phone:480-839-0206
Practice Address - Fax:480-839-0208
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44695207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology