1467525196 NPI number — DR. DEBORAH JEANNE JONES D.C.

Table of content: DR. DEBORAH JEANNE JONES D.C. (NPI 1467525196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467525196 NPI number — DR. DEBORAH JEANNE JONES D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
DEBORAH
Provider Middle Name:
JEANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

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:
1467525196
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
459 MARLBORO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIDGETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08302-6716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-455-7935
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 ROADSTOWN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHILOH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-455-4700
Provider Business Practice Location Address Fax Number:
856-455-1567
Provider Enumeration Date:
11/17/2006

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: 111N00000X , with the licence number:  38MC00454900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6720404 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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