| Jonathan L Crist Do, Llc | |
|
13a State St Bristol RI 02809-1811 | |
| (401) 254-1200 | |
| (401) 404-4301 |
| Full Name | Jonathan L Crist Do, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 13a State St, Bristol, Rhode Island |
| Authorized Official Name and Position | Jonathan L Crist (PSYCHIATRIST) |
| Authorized Official Contact | 4012541200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan L Crist Do, Llc 13a State St Bristol RI 02809-1811 Ph: (401) 254-1200 | Jonathan L Crist Do, Llc 13a State St Bristol RI 02809-1811 Ph: (401) 254-1200 |
| NPI Number | 1821663766 |
|---|---|
| Provider Enumeration Date | 05/24/2021 |
| Last Update Date | 05/24/2021 |
| Certification Date | 05/24/2021 |
| Medicare PECOS PAC ID | 2860898657 |
|---|---|
| Medicare Enrollment ID | O20210902000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821663766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jonathan L Crist |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336296326 PECOS PAC ID: 2466527858 Enrollment ID: I20080820000021 |
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