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Dr. Johnathan Mark Luth, DO
General Practice Physician in Jacksonville, Florida
NPI 1548903040

Johnathan Mark Luth is a General Practice Physician based in Bethesda, FL. Johnathan Mark Luth practices in Jacksonville, FL and has the professional credentials of DO. The NPI Number for Johnathan Mark Luth is 1548903040 and holds a License No. 0102208035 (Florida).

The current practice location address for Johnathan Mark Luth is 964 Ajax Street, Jacksonville, FL and can be reached out via phone at 904-546-7094.

Location: 964 Ajax Street, Jacksonville, FL, 20889-0004
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548903040
Provider Name
Johnathan Mark Luth
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
964 Ajax Street, Jacksonville, FL, 20889-0004
Phone Number
904-546-7094
Fax Number
Provider Enumeration Date
04/14/2022
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
964 Ajax Street
City
Jacksonville
State
Florida
Zip
32212
Phone Number
904-546-7094
Fax Number
person
Provider Business Mailing Address Details
Address
964 Ajax Street
City
Jacksonville
State
Florida
Zip
32212
Phone Number
904-546-7094
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
0102208035 (Virginia)
Definition
Definition to come...
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