Provider Demographics
NPI:1942655667
Name:BARNETT, JONATHAN ALBERT (MD, MHA)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ALBERT
Last Name:BARNETT
Suffix:
Gender:M
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W KINNICKINNIC RIVER PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3660
Mailing Address - Country:US
Mailing Address - Phone:414-385-2592
Mailing Address - Fax:414-385-2591
Practice Address - Street 1:2901 W KINNICKINNIC RIVER PKWY STE 315
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3660
Practice Address - Country:US
Practice Address - Phone:414-385-2592
Practice Address - Fax:414-385-2591
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125074761207R00000X
IL036158446207R00000X, 207RC0200X, 208M00000X
WI81737-20207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist