Provider Demographics
NPI:1962685545
Name:BINKERD, JON ERIC (MD,)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:ERIC
Last Name:BINKERD
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 1:1911 LAY DAM RD
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045-8351
Mailing Address - Country:US
Mailing Address - Phone:205-280-3248
Mailing Address - Fax:205-280-3369
Practice Address - Street 1:1911 LAY DAM RD
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-8351
Practice Address - Country:US
Practice Address - Phone:205-280-3248
Practice Address - Fax:205-280-3369
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31935208600000X
ALMD.31935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL149637Medicaid
ALR9469Medicaid