Maynard, Jonathan Ray

Maynard, Jonathan Ray is an sole proprietor health care provider with primary practice located at 2301 Lexington Ave Ste 135 , Ashland KY 41101-2800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Maynard, Jonathan Ray can be contacted via phone (606) 408-8400.

Contact Information

Primary practice address
2301 Lexington Ave Ste 135 Ashland KY 41101-2800
Phone: (606) 408-8400
Fax: (606) 408-6770
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X TP960 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 44675 Kentucky

Profile Details

NPI number 1992970115
LBN Legal business name Maynard, Jonathan Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 29th, 2008
Last updated Dec 1st, 2021 - about 5 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 1992970115 NPPES
Kentucky MEDICAID 7100173180
Kentucky MEDICAID 0050712
Kentucky MEDICAID 3810021011

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