Henry, Jonathon Charles

Henry, Jonathon Charles is an individual health care provider with primary practice located at 1111 Bayshore Dr , Manitowoc WI 54220-5548. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Henry, Jonathon Charles can be contacted via phone (920) 682-6376.

Contact Information

Primary practice address
1111 Bayshore Dr Manitowoc WI 54220-5548
Phone: (920) 682-6376
Fax: (920) 652-0115
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 42957-020 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 42957 Wisconsin

Profile Details

NPI number 1699744730
LBN Legal business name Henry, Jonathon Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Apr 9th, 2024 - about 2 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 1699744730 NPPES
Wisconsin MEDICAID 1699744730

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