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Individual

DR. JONATHAN TRENT MAGRUDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
242 KING AVENUE, SUITE 230, ATHENS, GA 30606
(706) 475-1700
Mailing address
242 KING AVENUE, SUITE 230, ATHENS, GA 30606

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
88653
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MT218334
PA
390200000X
Student in an Organized Health Care Education/Training Program
D77372
MD

Other

Enumeration date
02/01/2011
Last updated
05/24/2021
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