Individual
JONATHAN DAVID FRATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT OF PATHOLOGY, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13061
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110234
—
MS
05
—
134522
—
AL
05
—
156443
—
AL
01
—
220010996
RR MEDICARE
MS
01
—
P00648898
RR MEDICARE
MS
Enumeration date
06/20/2006
Last updated
04/05/2026
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