Provider Demographics
NPI:1427018050
Name:GARRISON, JONATHAN CROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CROSS
Last Name:GARRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4422 CARVER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5536
Mailing Address - Country:US
Mailing Address - Phone:513-984-2800
Mailing Address - Fax:513-984-2844
Practice Address - Street 1:4422 CARVER WOODS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5536
Practice Address - Country:US
Practice Address - Phone:513-984-2800
Practice Address - Fax:513-984-2844
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350556742084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35055674OtherOH STATE LICENSE