Individual
JONATHAN G AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
434 HOSPITAL DRIVE, LINVILLE, NC 28646
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9501480
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12280
BCBSNC
NC
01
—
195372
SC MEDICAID
SC
05
—
8912280
—
NC
01
—
P00270529
RR MEDICARE
NC
Enumeration date
05/09/2006
Last updated
09/04/2018
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