Provider Demographics
NPI:1700861713
Name:LONCAR, JEANINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:MARIE
Last Name:LONCAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:910 ADAMS ST SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3730
Mailing Address - Country:US
Mailing Address - Phone:256-533-7420
Mailing Address - Fax:256-536-4109
Practice Address - Street 1:540 HUGHES RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8999
Practice Address - Country:US
Practice Address - Phone:256-533-7420
Practice Address - Fax:256-464-0493
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL19601207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE706OtherMEDICARE
AL510-40086OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL510-79993OtherBCBS
ALG423OtherMEDICARE
AL102I167441OtherMEDICARE PTAN
AL102I167442OtherMEDICARE PTAN
AL510-12230OtherBLUE CROSS BLUE SHIELD OF ALABAMA
ALD084OtherMEDICARE
AL510-12183OtherBLUE CROSS BLUE SHIELD
AL102I167439OtherMEDICARE PTAN
AL510-12183OtherBLUE CROSS BLUE SHIELD