# JONATHON PENDERGRASS, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083913776
- **Authorized official:** JONATHON PENDERGRASS M.D. (OWNER)
- **Authorized official phone:** (251) 631-3534

## Contact information

- **Practice address:** 6801 AIRPORT BLVD, WCC/HBO, MOBILE, AL 36608-3709
- **Practice address phone:** (251) 631-3534
- **Practice address fax:** (251) 631-3531
- **Mailing address:** 6801 AIRPORT BLVD, WCC/HBO, MOBILE, AL 36608-3709
- **Mailing address phone:** (251) 631-3534
- **Mailing address fax:** (251) 631-3531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 12457 | AL | Yes |

## Other

- **Enumeration date:** 03/21/2011
- **Last updated:** 03/21/2011