Jonathan R Etter (NPI# 1508033432, PAC ID# 3870630007) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1508033432 |
| PAC ID by PECOS | 3870630007 |
| Professional Enrollment ID | I20120523000453 |
| Full Name | Jonathan R Etter |
| Organization Legal Name | PHYSICIANS EYE CARE CENTER LLC |
| Address |
2400 Longstone Ln Suite 206 Marriottsville MD 21104-1533 |
| Phone Number | 4104809966 |
| Gender | M |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 2001 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 9436175684 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1001 Pine Heights Ave, Baltimore, MD 21229-5208 | 4106449515 | PHYSICIANS EYE CARE CENTER LLC |
| 2400 Longstone Ln, Suite 206, Marriottsville, MD 21104-1533 | 4104809966 | PHYSICIANS EYE CARE CENTER LLC |
| Organization Legal Name | PHYSICIANS EYE CARE CENTER LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerome Ross | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Connie Marie Mcrill | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Jeffrey L Wexler | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Marjorie K Warden | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Alexandre F Gauthier | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Richard Malcolm Susel | Ophthalmology | Physicians Eye Care Center LLC | 11055 Little Patuxent Park, Suite 105, Columbia, MD 21044 |
| Street Address |
2400 LONGSTONE LN SUITE 206 |
| City | MARRIOTTSVILLE |
| State | MD |
| Zip | 21104-1533 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Risa W Huber | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Elizabeth Bower | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Ji Yon Kwon | Internal Medicine | Seton Medical Group Inc | 2400 Longstone Ln, Suite 106, Marriottsville, MD 21104-1532 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tavershima Asom | Nurse Practitioner | 7341 Argonne Dr, Marriottsville, MD 21104-1074 | |
| Linda S Crites | Clinical Social Worker | 2838 Hadel Dr, Marriottsville, MD 21104-1187 | |
| Katelyn M Roe | Occupational Therapy | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 | |
| Carolyn Dawn Dockins | Physical Therapy | Unbridled Rehabilitation Services | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 |
| Abigail H Mcnair | Occupational Therapy | Unbridled Rehabilitation Services | 840 Marriottsville Rd, Marriottsville, MD 21104-1331 |
| Jeffrey A Torockio | Physical Therapy | 2470 Longstone Ln, Suite K, Marriottsville, MD 21104-1515 | |
| Tracey M Reinecke-kashima | Nurse Practitioner | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Randal Paul Riesett | Internal Medicine | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| Jonathan Scott Fish | Internal Medicine | Charter Internal Medicine, LLC | 2470 Longstone Ln, Suite I, Marriottsville, MD 21104-1523 |
| City | MARRIOTTSVILLE |
| Zip Code | 21104 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | MARRIOTTSVILLE + OPHTHALMOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.