IndividualActive
Jonathan Minor, M.D.
NPI 1609195452 · Pediatric Sports Medicine Physician · Rolla, MO
Provider details
- NPI number
- 1609195452
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- A137057 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
910 W 10th St
Rolla, MO 65409-6519
Phone: (573) 342-4284
Fax: (573) 341-6967
Approximate (ZIP-level) locationGet directions
Mailing address
910 W 10th St
Rolla, MO 65409-6519
Registry dates
- Enumerated
- 2010-05-19
- Last updated
- 2026-03-30
- Certified
- 2026-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.