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Individual

NICHOLAS JONAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
940 E 5TH ST, COQUILLE, OR 97423-1699
(541) 396-3101
Mailing address
2250 HAYES ST, NORTH BEND, OR 97459-1775
(763) 370-7749

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
290156
MA
208600000X
Surgery Physician
70904
AZ
208600000X
Surgery Physician
Primary
MD224779
OR

Other

Enumeration date
05/17/2018
Last updated
11/03/2025
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