Individual
JEFFREY ROBERT SONNTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2310 CALIFORNIA RD STE A, ELKHART, IN 46514-1228
(574) 264-0791
Mailing address
2310 CALIFORNIA RD STE A, ELKHART, IN 46514-1228
(574) 264-0791
(574) 262-5183
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
02005363A
IN
207X00000X
Orthopaedic Surgery Physician
5101019939
MI
207X00000X
Orthopaedic Surgery Physician
R2019
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017400
—
IN
Enumeration date
06/26/2012
Last updated
12/03/2019
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