Provider Demographics
NPI:1598871360
Name:CROOPNICK, JONATHAN B (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:B
Last Name:CROOPNICK
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:70 WALNUT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-5312
Mailing Address - Country:US
Mailing Address - Phone:508-698-3266
Mailing Address - Fax:508-543-3046
Practice Address - Street 1:70 WALNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-5312
Practice Address - Country:US
Practice Address - Phone:508-698-3266
Practice Address - Fax:508-543-3046
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2016-12-30
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Provider Licenses
StateLicense IDTaxonomies
MA221375207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110081571AMedicaid
MA000712003Medicare PIN