| Jonathan Manzer | |
|
3071 S Grand Ave Carthage MO 64836-7851 | |
| (417) 358-4811 | |
| Not Available |
| Full Name | Jonathan Manzer |
|---|---|
| Speciality | Family Medicine |
| Location | 3071 S Grand Ave, Carthage, Missouri |
| Authorized Official Name and Position | Jonathan Lyle Manzer (PHYSICIAN) |
| Authorized Official Contact | 4173584811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Manzer 3071 S Grand Ave Carthage MO 64836-7851 Ph: (417) 358-4811 | Jonathan Manzer 3071 S Grand Ave Carthage MO 64836-7851 Ph: (417) 358-4811 |
| NPI Number | 1982731444 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 11/25/2013 |
| Medicare PECOS PAC ID | 8628058013 |
|---|---|
| Medicare Enrollment ID | O20040726000283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982731444 | NPI | - | NPPES |
| 209288406 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2004001464 (Missouri) | Primary |
| Provider Name | Margaret C Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104853050 PECOS PAC ID: 6406847367 Enrollment ID: I20040519001386 |
| Provider Name | Jonathan L Manzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407848971 PECOS PAC ID: 5799765178 Enrollment ID: I20040726000227 |
| Provider Name | Crystal J Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053861609 PECOS PAC ID: 3476832189 Enrollment ID: I20161122000054 |
| Provider Name | Ruth A West |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295265114 PECOS PAC ID: 4486925690 Enrollment ID: I20170807002198 |
| Provider Name | Jody M Pryor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629602024 PECOS PAC ID: 8123459112 Enrollment ID: I20200506002997 |
| Provider Name | Aubri D Ashbacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528677200 PECOS PAC ID: 1557743036 Enrollment ID: I20220729002779 |
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