Organization
JONATHAN F. DILLER, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN FORD DILLER M.D. (PRESIDENT)
(419) 332-9978
Entity
Organization
Contact information
Practice address
2575 HAYES AVE, SUITE 4, FREMONT, OH 43420-5201
(419) 332-9978
(419) 332-7989
Mailing address
2575 HAYES AVE, SUITE 4, FREMONT, OH 43420-5201
(419) 332-9978
(419) 332-7989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-045285
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2811407
—
OH
01
—
35-045285
OH MEDICAL LICENSE
OH
Enumeration date
07/15/2006
Last updated
05/28/2008
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