1376524082 NPI number — BEN MORGAN JONES PH.D.

Table of content: APRIL MARIE TATARSKY (NPI 1720751555)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376524082 NPI number — BEN MORGAN JONES PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
BEN
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376524082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2633 BROAD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16601-1914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-946-1423
Provider Business Mailing Address Fax Number:
814-946-1423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2633 BROAD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-1423
Provider Business Practice Location Address Fax Number:
814-946-1423
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  PS004444L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 109556 . This is a "TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2015094 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 119532 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: FOCUS . This is a "740812" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 109556 . This is a "VALUE OPTIONS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0004347392 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232147 . This is a "MHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 849747 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 849747 . This is a "AFFORDABLE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA20266 . This is a "ADVANTAGE HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: VI7661 . This is a "EMPIRE BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012221930001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00022445 . This is a "RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: A19532 . This is a "ICHP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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