Provider Demographics
NPI:1023088051
Name:GRINER, JONATHAN H (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:GRINER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-721-5700
Mailing Address - Fax:717-715-1296
Practice Address - Street 1:175 MARTIN AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1761
Practice Address - Country:US
Practice Address - Phone:717-721-5700
Practice Address - Fax:717-715-1296
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422243207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001955281Medicaid
PA001955281Medicaid
PA071052ESCMedicare ID - Type Unspecified