Provider Demographics
NPI:1508115437
Name:FROHNING, JONATHAN R (DPT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:FROHNING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:812-759-7451
Mailing Address - Fax:812-401-3259
Practice Address - Street 1:1302 AVENUE OF MID AMERICA STE 3
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-4647
Practice Address - Country:US
Practice Address - Phone:812-477-1558
Practice Address - Fax:812-474-2296
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010912A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000790339OtherBLUE CROSS BLUE SHIELD
IN000000790980OtherBLUE CROSS BLUE SHIELD
IN201117050Medicaid
IN000000790965OtherBLUE CROSS BLUE SHIELD
IN000000790980OtherBLUE CROSS BLUE SHIELD
IN198850006Medicare UPIN
IN255480004Medicare UPIN