MEDICARE: DR. JUDITH ANN JONKE D.P.M.

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	213EP1101X	Primary Podiatric Medicine Podiatrist	0762	TX

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	:	1174699409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH ANN JONKE D.P.M.

Provider Business Mailing Address
First Line	:	925 LOOP 337
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3556
Country	:	US
Telephone Number	:	830-629-7233
Fax Number	:	830-620-5679

Provider Business Practice Location Address
First Line	:	925 LOOP 337
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3556
Country	:	US
Telephone Number	:	830-629-7233
Fax Number	:	830-620-5679

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	01/07/2008

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