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Contact Information

JONATHON L ENNIS, PAC
805 BARDSTOWN RD
SPRINGFIELD, KY40069
 Phone: 859-481-7113
 Fax: 859-481-7114
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JONATHON L ENNIS · (Male)

NPI Number 1497267637
Status Active
Credentials PAC
Entity Individual
Enumeration date 10/27/2017
Last updated 03/28/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • KY Medicaid 7100515140
Hospital affiliation(s)
  • HARDIN MEMORIAL HOSPITAL - (Acute Care)
    913 NORTH DIXIE AVENUE
    ELIZABETHTOWN, KY 42701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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