Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME63253 | FL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | ME63253 | FL |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME63253 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME63253 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME63253 | FL |
NPI | 1801890264 |
---|---|
Provider Name | Milton John Vonthron |
First Address | Atlanta, GA 30368-7345 |
Second Address | Jacksonville Beach, FL 32250-3265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200024455 | RAILROAD MEDICARE (01) | FL |
3795195-00 | (05) | FL |
G25288 | (02) | FL |