DR. JONATHAN RUSSELL MARK (NPI# 1902048952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902048952 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN RUSSELL MARK |
| Credential | M.D. |
| Practice Address |
1055 Summitt Dr Middletown OH 45042-3464 |
| Mailing Address |
Po Box 636256 Cincinnati OH 45263-6256 |
| Practice Telephone | 5134758400 |
| Practice Fax Number | 5132174738 |
| Mailing Telephone | 5135855507 |
| Mailing Fax Number | 5135855511 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2017-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 35.124086 | OH | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 0116021508 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114018363 | Jonathan B Mark | Anesthesiology | 508 Fulton Street, Va Medical Center, Durham, NC 27705 | 2006-09-27 |
| Street Address |
1055 SUMMITT DR |
| City | MIDDLETOWN |
| State | OH |
| Zip Code | 45042-3464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518090646 | Sharon Lynne Fritz | Physician Assistant | 1055 Summitt Dr, Middletown, OH 45042-3464 | 2007-03-14 |
| 1548643190 | Samantha Marie Bunge | Audiologist | 1055 Summitt Dr, Middletown, OH 45042-3464 | 2015-07-01 |
| 1144611062 | Melinda Spofford | Licensed Practical Nurse | 1055 Summitt Dr, Middletown, OH 45042-3464 | 2015-02-13 |
| 1750772679 | Verna King | Licensed Practical Nurse | 1055 Summitt Dr, Middletown, OH 45042-3464 | 2015-02-13 |
| 1467879007 | Ear Nose and Throat Specialists of Middletown, Inc | Clinic/Center | 1055 Summitt Dr, Middletown, OH 45042-3464 | 2014-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413919 | Stacey Ward | Nurse Practitioner | 1055 Summit Dr., Middletown, OH 45042 | 2020-07-06 |
| 1962978759 | Stephani Chandra Miller | Counselor | 160 N. Breiel Blvd, Middletown, OH 45042 | 2018-10-18 |
| 1124504378 | Butler County Community Health Consortium, Inc. | Clinic/Center | 601 N Breiel Blvd Ste B, Middletown, OH 45042 | 2018-07-11 |
| 1417474883 | Tiffany Marie Ott | Registered Nurse | 1229 Ellen Dr, Middletown, OH 45042 | 2017-08-27 |
| 1184074650 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 1909 Jackson Lane, Middletown, OH 45042 | 2016-06-15 |
| 1639529100 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4623 Central Avenue, Middletown, OH 45042 | 2016-06-15 |
| 1811347388 | Camelot Raalty, LLC | Intermediate Care Facility, Mentally Retarded | 4923 Hendrickson Rd, Middletown, OH 45042 | 2016-06-15 |
| 1790135234 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4895 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1720438294 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4907 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1174948129 | Sherry L. Flannery | Nurse Practitioner | 4961 Middletown Oxford Road, Middletown, OH 45042 | 2014-02-27 |
| Find all providers in zip 45042 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790856128 | Ear Nose & Throat Specialists of Middletown Inc. | Otolaryngology | 1055 Summitt Drive, Middletown, OH 45042-3464 | 2006-11-09 |
| 1427088376 | Louis George Petcu | Otolaryngology | 75 Crystal Run Rd Ste 220, Middletown, NY 10941 | 2006-07-04 |
| 1033148473 | John Francis Barrord | Otolaryngology | 1055 Summit Drive, Middletown, OH 45042-3464 | 2006-06-30 |
| 1912901869 | Steven Franklin Freedman | Otolaryngology | 850 Aquidneck Ave, Unit B9, Middletown, RI 02842-7244 | 2005-06-09 |
| 1063788461 | Sameep P. Kadakia | Otolaryngology | 4222 Grand Ave, Middletown, OH 45044 | 2012-03-29 |
| 1770735607 | Aleksandr Guchinskiy | Otolaryngology | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2008-10-22 |
| 1689772287 | Ear Nose & Throat Medicine and Surgery Group, LLC | Otolaryngology | 850 Aquidneck Ave, Middletown, RI 02842-7244 | 2006-09-20 |
| 1396847117 | Karen Esther Paul | Otolaryngology | 75 Crystal Run Rd, Building B, Suite 220, Middletown, NY 10941-7000 | 2006-09-02 |
| 1568424935 | Lissette Giraud | Otolaryngology | 155 Crystal Run Rd, Middletown, NY 10941-4028 | 2006-04-03 |
| 1063494185 | Kweon Stambaugh | Otolaryngology | 155 Crystal Run Rd, Middletown, NY 10941-4028 | 2005-11-15 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 45042 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.