Provider Demographics
NPI:1508188996
Name:JONATHAN MCCONE JR. MD PC
Entity Type:Organization
Organization Name:JONATHAN MCCONE JR. MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:703-780-0994
Mailing Address - Street 1:6196 OXON HILL RD STE 640
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3112
Mailing Address - Country:US
Mailing Address - Phone:703-780-0994
Mailing Address - Fax:703-780-0920
Practice Address - Street 1:6196 OXON HILL RD STE 640
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3112
Practice Address - Country:US
Practice Address - Phone:301-567-2400
Practice Address - Fax:301-567-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022884400Medicaid
MD185321000Medicaid
DC022884400Medicaid
MD185321000Medicaid