Provider Demographics
NPI:1700849510
Name:THATCHER, JONATHAN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHARLES
Last Name:THATCHER
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 1:17 BELMONT AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6613
Mailing Address - Country:US
Mailing Address - Phone:802-254-3500
Mailing Address - Fax:802-254-5937
Practice Address - Street 1:17 BELMONT AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6613
Practice Address - Country:US
Practice Address - Phone:802-254-3500
Practice Address - Fax:802-254-5937
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN0841Medicaid
VTVN0841Medicare ID - Type Unspecified
VTOVN0841Medicaid