Individual
DR. JONATHAN EDWARD KINTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
517 LINCOLN WAY E, MISHAWAKA, IN 46544-2211
(574) 255-3188
(574) 255-4182
Mailing address
517 LINCOLN WAY E, MISHAWAKA, IN 46544-2211
(574) 255-3188
(574) 255-4182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001487
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000506038
BLUE CROSS BLUE SHIELD
IN
05
—
100279600A
—
IN
01
—
1053494328
NPI
IN
Enumeration date
10/23/2006
Last updated
06/06/2008
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