MEDICARE: JONATHAN B BINGHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MD424275	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063449809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN B BINGHAM MD

Provider Business Mailing Address
First Line	:	2100 MACK BLVD
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-5622
Country	:	US
Telephone Number	:	484-884-0617
Fax Number	:	484-884-0628

Provider Business Practice Location Address
First Line	:	1250 S CEDAR CREST BLVD STE 215
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18103-6271
Country	:	US
Telephone Number	:	484-884-0617
Fax Number	:	484-884-0628

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	08/18/2020

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