Provider Demographics
NPI:1639205289
Name:EHRHARDT, JONATHAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:S
Last Name:EHRHARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3970 N RIVER BLUFF PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-2057
Mailing Address - Country:US
Mailing Address - Phone:520-290-1105
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5067
Practice Address - Country:US
Practice Address - Phone:520-626-7402
Practice Address - Fax:520-626-2941
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ354142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology