Individual
MR. JONATHAN DAVID ERPENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BLDG. H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND, ATTN: MED STAFF SERVICES, JACKSONVILLE, FL 32212-0140
(202) 762-3194
Mailing address
BLDG. H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND, ATTN: MED STAFF SERVICES, JACKSONVILLE, FL 32212-0140
(202) 762-3194
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01062572A
IN
208D00000X
General Practice Physician
01062572A
IN
Other
Enumeration date
09/16/2006
Last updated
10/02/2023
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