Individual
DR. JONATHON CHARLES HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 BAYSHORE DR, MANITOWOC, WI 54220-5548
(920) 682-6376
(920) 652-0115
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
42957
WI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
42957-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699744730
—
WI
Enumeration date
03/14/2006
Last updated
04/21/2026
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