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Individual
JONATHAN R ERNST
Active
Individual
JONATHAN R ERNST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67864-20
WI
207R00000X
Internal Medicine Physician
67864-20
WI
208000000X
Pediatrics Physician
67864-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548675697
—
WI
Enumeration date
06/27/2014
Last updated
05/24/2022
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