Staidle, Jonathan Patrick
Staidle, Jonathan Patrick is an individual health care provider with primary practice located at 4814 Sparks Blvd , Sparks NV 89436-8219. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Staidle, Jonathan Patrick can be contacted via phone (775) 327-0699.Contact Information
Primary practice address
4814 Sparks Blvd
Sparks NV 89436-8219
Phone: (775) 327-0699
Fax: (775) 451-7501
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | MD457066 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 35-126612 | Ohio |
Profile Details
| NPI number | 1982994455 |
|---|---|
| LBN Legal business name | Staidle, Jonathan Patrick |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2011 |
| Last updated | Jan 19th, 2021 - about 4 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 | 1982994455 | NPPES |
| Ohio | MEDICAID | 0129749 |
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