Individual
JONATHAN F. KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
488 PLEASANT ST, WORCESTER, MA 01609-1857
(508) 755-9573
Mailing address
126 BUSHY LN, RUTLAND, MA 01543-2025
(508) 886-6280
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
2087
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019046
NEIGHBORHOOD HEALTH
MA
01
—
002087
TUFTS HEALTH PLAN
MA
05
—
0316644
—
MA
01
—
2700355
UNITED HEALTHCARE
MA
01
—
333402
HARVARD PILGRIM HEALTH
MA
01
—
Y71045
BLUE SHIELD OF MA
MA
Enumeration date
10/06/2006
Last updated
03/25/2008
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