Provider Demographics
NPI:1124067053
Name:REHBERG, JONATHAN FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:FRANCIS
Last Name:REHBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W FORT WILLIAMS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2433
Mailing Address - Country:US
Mailing Address - Phone:256-249-6995
Mailing Address - Fax:256-245-6992
Practice Address - Street 1:315 W FORT WILLIAMS ST STE 100
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2433
Practice Address - Country:US
Practice Address - Phone:256-249-6995
Practice Address - Fax:256-245-6992
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28010207V00000X
MS18619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911203Medicaid