Jonathan Edwin Fountain, MD is a
Family Medicine physician based in Carrabelle, Florida. Jonathan Edwin Fountain is licensed to practice in Florida (license number ME0050330) and his current practice location is 110 Ne 5th St, Carrabelle, Florida. He can be reached at his office (for appointments etc.) via phone at
(850) 653-8853.
NPI number for Jonathan Edwin Fountain is 1356334049 and his current mailing address is Po Box 580, Apalachicola, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356334049.
Physician's Profile
| Full Name | Jonathan Edwin Fountain |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 110 Ne 5th St, Carrabelle, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356334049
- Provider Enumeration Date: 08/26/2005
- Last Update Date: 11/27/2015
Medical Identifiers
Medical identifiers for Jonathan Edwin Fountain such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356334049 | NPI | - | NPPES |
| 015154400 | Medicaid | FL | |
| 015159600 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | ME0050330 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Edwin Fountain is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| 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 |
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