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General NPI Number Information
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NPI Number | 1366645178
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Entity Type | Individual
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Provider Name | JONATHAN D SCHROCK MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 2310 CALIFORNIA ROAD
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City | ELKHART
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State | IN
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Zip | 46514-1228
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Country | US
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Telephone | 574-264-4163
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Fax | 574-262-9650
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Provider Business Mailing Address
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Address Line | 2310 CALIFORNIA ROAD
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City | ELKHART
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State | IN
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Zip | 46514-1228
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Country | US
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Telephone | 574-264-4163
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Fax | 574-262-9650
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01063795A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 01063795A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 01063795A
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License Number State | IN
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