Individual
JONATHAN G. KERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
055853
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10045388
AMERIGROUP
GA
01
—
340860
WELLCARE
GA
05
—
461306198B
—
GA
05
—
461306198D
—
GA
01
—
52182967
BCBS
GA
01
—
7769920
CIGNA
GA
Enumeration date
02/02/2006
Last updated
12/02/2020
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