Provider Demographics
NPI:1396170619
Name:SKONER, JONATHAN DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:SKONER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:110 VIP DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-6923
Mailing Address - Country:US
Mailing Address - Phone:724-935-9999
Mailing Address - Fax:724-935-9974
Practice Address - Street 1:110 VIP DR
Practice Address - Street 2:SUITE 301
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6923
Practice Address - Country:US
Practice Address - Phone:724-935-9999
Practice Address - Fax:724-935-9974
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA002819152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist