Provider Demographics
NPI:1700382694
Name:HESTER, JONATHAN DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:DAVID
Last Name:HESTER
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 1:2874 N CARSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-1683
Mailing Address - Country:US
Mailing Address - Phone:775-445-5500
Mailing Address - Fax:
Practice Address - Street 1:2874 N CARSON ST STE 300
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1683
Practice Address - Country:US
Practice Address - Phone:775-445-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA956242085R0202X
NV258902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR228388795Medicaid