Provider Demographics
NPI:1841214541
Name:AYERS, JONATHAN WT (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:WT
Last Name:AYERS
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 1:2120 AUTUMN HILL DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2176
Mailing Address - Country:US
Mailing Address - Phone:734-747-8645
Mailing Address - Fax:
Practice Address - Street 1:3145 W CLARK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1120
Practice Address - Country:US
Practice Address - Phone:734-434-4766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040435207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJA040435OtherMI LICENSE
MIJA040435OtherMI LICENSE