Provider Demographics
NPI:1346355724
Name:STROEBEL, JONATHAN K (DPM)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:K
Last Name:STROEBEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:420 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-4560
Mailing Address - Country:US
Mailing Address - Phone:920-926-8340
Mailing Address - Fax:920-926-8370
Practice Address - Street 1:421 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-8335
Practice Address - Country:US
Practice Address - Phone:920-926-8282
Practice Address - Fax:920-926-8971
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI818213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
393686460004OtherANTHEM BCBS OF WI
480031185OtherRAILROAD MEDICARE
WI43229700Medicaid
U80825Medicare UPIN