Provider Demographics
NPI:1992826903
Name:JODON, THOMAS ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:JODON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LEBANON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4192
Mailing Address - Country:US
Mailing Address - Phone:724-439-9445
Mailing Address - Fax:724-439-4021
Practice Address - Street 1:66 LEBANON AVE STE B
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4192
Practice Address - Country:US
Practice Address - Phone:724-439-9445
Practice Address - Fax:724-439-4021
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003369L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAJO447693OtherPROVIDER NUMBER
PAU08175Medicare UPIN