Provider Demographics
NPI:1568405041
Name:GIOMETTI, JON A (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:A
Last Name:GIOMETTI
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:PO BOX 643403
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-0001
Mailing Address - Country:US
Mailing Address - Phone:800-299-4564
Mailing Address - Fax:
Practice Address - Street 1:810 FAIRGROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9617
Practice Address - Country:US
Practice Address - Phone:828-326-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200364207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00182048OtherRAILROAD
7388297OtherMAMSI
NC891315AMedicaid
D8979OtherMEDCOST
1315AOtherBCBS
SCQ0036EMedicaid
D8979OtherMEDCOST
NC891315AMedicaid