Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JONATHAN DALE PRIVETT, M.D.
ActiveJONATHAN DALE PRIVETT, M.D. is a Family Medicine healthcare provider located in LAURIE, Missouri. NPI 1912945957 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · LAURIE, MO
Registration Details
- NPI Number
- 1912945957
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 3, 2006 (20.19094763087 yrs)
- Last Updated
- May 7, 2018
- Licenses
-
2003001992 (MO)2003001992 (MO)
Practice Information
- Address
-
156 MISSOURI BLVDSTE BLAURIE, MO, 65038Browse MO providers · Browse ZIP 65038
- Phone
- 5733745263
- Fax
- 5733744933
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.