Provider Demographics
NPI:1578251294
Name:GEHRINGER, JOHNATHAN WILLIAM
Entity Type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:WILLIAM
Last Name:GEHRINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45113-9700
Mailing Address - Country:US
Mailing Address - Phone:513-835-6943
Mailing Address - Fax:
Practice Address - Street 1:731 LEBANON RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45113-9700
Practice Address - Country:US
Practice Address - Phone:513-835-6943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00003058363747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant