Jonathan M Mongold
Family Doctor Emergency Physician Family Doctor - Sports Medicine
5177 Mccarty Ln
Lafayette
, Indiana 47905-8764
Jonathan M Mongold
Family Doctor Emergency Physician Family Doctor - Sports Medicine
5177 Mccarty Ln
Lafayette
, Indiana 47905-8764
(877) 668-5621
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About
Features
Specialties
- Emergency Physician
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Jonathan M Mongold
- 1200 W White River Blvd # 4300
- Muncie, IN
- Zip : 47303-4988
- Phone : (877) 668-5621
Second Address
- Jonathan M Mongold
- 5177 Mccarty Ln
- Lafayette, IN
- Zip : 47905-8764
- Phone : (765) 448-8000
Reviews
FAQs
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What type of doctor is Jonathan M Mongold
In what state does Jonathan M Mongold practice in?
Where is Jonathan M Mongold ’s practice located?
What is Jonathan M Mongold ’s gender?
Is Jonathan M Mongold a sole practitioner?
Is Jonathan M Mongold accepting new patients?
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Does Jonathan M Mongold offers telemedicine?
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What is Jonathan M Mongold ’s NPI number?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 02005180A | IN |
| Y | 207Q00000X | Family Doctor | 02005180A | IN |
| N | 207QS0010X | Family Doctor - Sports Medicine | 02005180A | IN |
National Provider Identifier
| NPI | 1205179553 |
|---|---|
| Provider Name | Jonathan M Mongold |
| First Address | Muncie, IN 47303-4988 |
| Second Address | Lafayette, IN 47905-8764 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/04/2013 |
| Last Update Date | 27/01/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000001106441 | ANTHEM SPORTS MED PIN (01) | IN |
| 000001116759 | ANTHEM FAMILY MED PIN (01) | IN |
| 000001117320 | ANTHEM URGENT CARE PIN (01) | IN |
| 300005550 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.