Individual
MR. JONATHAN MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 DUTCHMANS LN, LOUISVILLE, KY 40207-4714
(502) 893-1000
Mailing address
PO BOX 6658, LOUISVILLE, KY 40206-0658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2021
Last updated
07/27/2023
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