ANTONIO F MENDIOLA JR. (NPI# 1659379915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659379915 |
| Entity Type | Individual |
| Full Name | ANTONIO F MENDIOLA JR. |
| Credential | M.D. |
| Practice Address |
1827 Greenwood Rd Prescott MI 48756-8626 |
| Practice Telephone | 9898736200 |
| Practice Fax Number | 9898735563 |
| Mailing Telephone | 9898736200 |
| Mailing Fax Number | 9898735563 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 046416 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3038010 | 05 |
| Street Address |
1827 GREENWOOD RD |
| City | PRESCOTT |
| State | MI |
| Zip Code | 48756-8626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881679645 | Sterling Area Health Center | Clinic/Center | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932571056 | Gabriel Wayne Wallace | Technician | 5208 Michiban Ave., Prescott, MI 48756 | 2015-10-28 |
| 1881622835 | Prescott Clinic P.C. | Family Medicine | 125 Washington, Prescott, MI 48756 | 2006-06-29 |
| 1568005569 | Jennifer Lynn Datzko | Nurse Practitioner | 125 N Washington St, Prescott, MI 48756-5117 | 2019-10-22 |
| 1295248508 | Prescott Clinic P.C. | Family Medicine | 125 N Washington St, Prescott, MI 48756-5117 | 2017-11-08 |
| 1407194954 | Jimmie S Ward Sr. | Physician Assistant | 125 Washington Ave, Prescott, MI 48756-5117 | 2013-01-17 |
| 1992831960 | Charles E Jessup | Family Medicine | 125 N Washington St, Prescott, MI 48756-5117 | 2007-02-26 |
| 1578626735 | Richard Steven Gaft | Emergency Medicine | 125 N Washington St, Box 114, Prescott, MI 48756-5117 | 2006-12-19 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1750319083 | Daniel Edward Greene | Chiropractor | 1818 Greenwood Rd, Prescott, MI 48756-8627 | 2006-06-28 |
| 1619477338 | Corinne Crawford | Behavior Technician | 3909 Rifle River Trl, Prescott, MI 48756-9345 | 2018-02-19 |
| Find all providers in zip 48756 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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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.