Healthcare Provider Details

I. General information

NPI: 1902897671
Provider Name (Legal Business Name): JOHN ROBERT LONAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 GREENWAY RD SUITE 200
BOONE NC
28607-4809
US

IV. Provider business mailing address

579 GREENWAY RD SUITE 200
BOONE NC
28607-4809
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-0100
  • Fax: 828-264-7592
Mailing address:
  • Phone: 828-262-0100
  • Fax: 828-264-7592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9800615
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: