Pittard, Jonathan B
Pittard, Jonathan B is an sole proprietor health care provider with primary practice located at 243 Cheney Dr W Ste 200 , Twin Falls ID 83301-4278. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Pittard, Jonathan B can be contacted via phone (208) 736-7422.Contact Information
Primary practice address
243 Cheney Dr W Ste 200
Twin Falls ID 83301-4278
Phone: (208) 736-7422
Fax: (208) 736-8905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA804 | Idaho |
Profile Details
| NPI number | 1376876599 |
|---|---|
| LBN Legal business name | Pittard, Jonathan B |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 8th, 2009 |
| Last updated | Dec 4th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376876599 | NPPES |
| Idaho | Other | PA804 | LICENSE NUMBER |
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