MEDICARE: JONATHAN HAVENS BRIGGS 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	2085R0001X	Radiation Oncology Physician	25MA07260000	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00010444	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700880069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN HAVENS BRIGGS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845592
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5592
Country	:	US
Telephone Number	:	855-709-4531
Fax Number	:	302-733-0854

Provider Business Practice Location Address
First Line	:	1945 ROUTE 33
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-4859
Country	:	US
Telephone Number	:	732-776-4404
Fax Number	:	732-776-4672

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	02/04/2014

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