Baltzell, Jonathan Robert

Baltzell, Jonathan Robert is an individual health care provider with primary practice located at 10210 Couloak Dr Suite E, Charlotte NC 28216-7679. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Baltzell, Jonathan Robert can be contacted via phone (704) 801-2000.

Contact Information

Primary practice address
10210 Couloak Dr Suite E Charlotte NC 28216-7679
Phone: (704) 801-2000
Fax: (704) 801-2001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 102359 North Carolina

Profile Details

NPI number 1457350258
LBN Legal business name Baltzell, Jonathan Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Apr 1st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457350258 NPPES
North Carolina MEDICAID 1457350258
North Carolina Other 2747011C
North Carolina MEDICAID 8101948

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