Provider Demographics
NPI:1194984989
Name:TONGSON, JONATHAN MARK (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MARK
Last Name:TONGSON
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 1:800 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2882
Mailing Address - Country:US
Mailing Address - Phone:740-454-5000
Mailing Address - Fax:
Practice Address - Street 1:800 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2882
Practice Address - Country:US
Practice Address - Phone:740-454-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11013853A207ZP0102X
OH35.099496207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology