MEDICARE: DR. JONATHAN NEIL SHERROD M.D.

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	207L00000X	Anesthesiology Physician	56631	TN

General Provider Information

NPI Number	:	1144513326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN NEIL SHERROD M.D.

Provider Business Mailing Address
First Line	:	3410 WHEATON RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-2695
Country	:	US
Telephone Number	:	901-606-6267
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DRIVE
Second Line	:	MCHE-QD (CREDS)
City	:	APO
State	:	AA
Zip	:	78234-6200
Country	:	US
Telephone Number	:	210-916-2460
Fax Number	:

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

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	04/17/2019

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