Jonathan E Fountain Md | |
5976 Berryhill Rd Milton FL 32570 | |
(850) 626-0400 | |
(850) 626-0204 |
Full Name | Jonathan E Fountain Md |
---|---|
Speciality | Family Medicine |
Location | 5976 Berryhill Rd, Milton, Florida |
Authorized Official Name and Position | Jonathan E Fountain (SOLE OWNER PRACTITIONER) |
Authorized Official Contact | 8506260400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jonathan E Fountain Md 5976 Berryhill Rd Milton FL 32570 Ph: (850) 626-0400 | Jonathan E Fountain Md 5976 Berryhill Rd Milton FL 32570 Ph: (850) 626-0400 |
NPI Number | 1255404620 |
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Provider Enumeration Date | 11/15/2006 |
Last Update Date | 03/07/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255404620 | NPI | - | NPPES |
50330 | Other | FL | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 50330 (Florida) | Primary |
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