Shaffer, Johnathon Patrick
Shaffer, Johnathon Patrick is an individual health care provider with primary practice located at 583 S Clarizz Blvd , Bloomington IN 47401-5515. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Shaffer, Johnathon Patrick can be contacted via phone (812) 676-4460.Contact Information
Primary practice address
583 S Clarizz Blvd
Bloomington IN 47401-5515
Phone: (812) 676-4460
Fax: (812) 355-4092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | A167677 | California |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01085483A | Indiana |
Profile Details
| NPI number | 1598129678 |
|---|---|
| LBN Legal business name | Shaffer, Johnathon Patrick |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2016 |
| Last updated | Jul 30th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598129678 | NPPES |
| Indiana | Other | 090540643 | MEDICARE PTAN |
| Indiana | Other | 000001581445 | MEDICARE PTAN |
| Indiana | MEDICAID | 300053899 | MEDICARE PTAN |
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