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General NPI Number Information
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NPI Number | 1992185292
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Entity Type | Individual
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Provider Name | JONATHAN EDGINGTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 9900 COLUMBIA AVE
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City | MUNSTER
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State | IN
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Zip | 46321-4008
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Country | US
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Telephone | 219-924-3300
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Fax | 219-922-5424
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Provider Business Mailing Address
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Address Line | 8558 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7032
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Country | US
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Telephone | 219-392-7084
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Fax | 219-703-6854
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 125066941
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01085798A
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License Number State | IN
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