JONATHON R WOLOCKO (NPI# 1386937787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386937787 |
| Entity Type | Individual |
| Full Name | JONATHON R WOLOCKO |
| Credential | M.D. |
| Practice Address |
210 N Lafayette St South Lyon MI 48178-2048 |
| Mailing Address |
391 Lansdowne Dr Westland MI 48185-3492 |
| Practice Telephone | 2484371744 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2018-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301098851 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
210 N LAFAYETTE ST |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178-2048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104820463 | Thomas Joseph Anan | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2005-06-02 |
| 1801304928 | Danielle Marie Konja | Behavioral Analyst | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2018-01-11 |
| 1063949121 | Lauren Elizabeth Carney | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2017-05-18 |
| 1124471933 | Monica Kandola | Student in an Organized Health Care Education/Training Program | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2016-07-16 |
| 1780036855 | Jeffrey Lau | Student in an Organized Health Care Education/Training Program | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2016-07-12 |
| 1053793067 | Steve Sungmin Kim | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2015-06-25 |
| 1649683590 | Maria Kostritsyna | Family Medicine | 210 N Lafayette St, Providence Medical Center, South Lyon, MI 48178-2048 | 2014-06-09 |
| 1982049003 | Lauren Powers | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2013-05-02 |
| 1295094407 | Nina Desai | Family Medicine | 210 N Lafayette St, Providence Medical Center, South Lyon, MI 48178-2048 | 2012-05-08 |
| 1104185693 | Renee Beth Stechow | Nurse Practitioner | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2012-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1255722088 | Jennifer Nidetz | Social Worker | 23015 Cheyenne Dr, South Lyon, MI 48178 | 2015-02-16 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| Find all providers in zip 48178 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1629200159 | Designed Altobaric Technology Inc | Family Medicine | 21800 Pontiac Trl, South Lyon, MI 48178-9499 | 2009-08-18 |
| 1386889954 | Hpc Health Pllc | Family Medicine | 22990 Pontiac Trl, South Lyon, MI 48178-1641 | 2008-12-10 |
| 1609036409 | Srikar T Reddy | Family Medicine | 51619 10 Mile Rd, South Lyon, MI 48178-9720 | 2008-06-15 |
| 1871705129 | Brandy Eberhardt | Family Medicine | 26006 Pontiac Trl, South Lyon, MI 48178-8050 | 2007-05-07 |
| 1386612406 | Mark Zawisa | Family Medicine | 23200 Pontiac Trl Ste 100, South Lyon, MI 48178-1983 | 2006-03-14 |
| 1083614002 | Promita Roychoudhury | Family Medicine | 210 N Lafayette, South Lyon, MI 48178 | 2005-08-01 |
| 1770582793 | Patrick R Brennan | Family Medicine | 22024 Pontiac Trl, South Lyon, MI 48178-9410 | 2005-07-20 |
| 1104820463 | Thomas Joseph Anan | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2005-06-02 |
| Find all providers in SOUTH LYON | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
Please comment or provide details below to improve the information on JONATHON R WOLOCKO.
| 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.