| Jonathan Edwin Fountain, MD | |
|
110 Ne 5th St, Carrabelle, FL 32322-3529 | |
| (850) 653-8853 | |
| (850) 653-1897 |
| Full Name | Jonathan Edwin Fountain |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 110 Ne 5th St, Carrabelle, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356334049 | NPI | - | NPPES |
| 015154400 | Medicaid | FL | |
| 015159600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0050330 (Florida) | Primary |
| Entity Name | Solantic/south Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851344378 PECOS PAC ID: 5496762171 Enrollment ID: O20060321000740 |
| Entity Name | Solantic Of Jacksonville Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407893100 PECOS PAC ID: 1052409307 Enrollment ID: O20071120000271 |
| Entity Name | Hma-solantic Joint Venture Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689812109 PECOS PAC ID: 6002955788 Enrollment ID: O20091209000716 |
| Entity Name | Shands-solantic Joint Venture Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558595223 PECOS PAC ID: 4183764178 Enrollment ID: O20091223000343 |
| Entity Name | Franklin County Board Of County Commissioners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033438627 PECOS PAC ID: 3274541115 Enrollment ID: O20110218000010 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Edwin Fountain, MD Po Box 580, Apalachicola, FL 32329-0580 Ph: (850) 653-8853 | Jonathan Edwin Fountain, MD 110 Ne 5th St, Carrabelle, FL 32322-3529 Ph: (850) 653-8853 |
Dr. Lionel B Catlin, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1581 Highway 98 W, Carrabelle, FL 32323 Phone: 850-697-3420 Fax: 850-697-3423 |