1023155223 NPI number — DR. RICHARD JONES M D

Table of content: DR. RICHARD JONES M D (NPI 1023155223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023155223 NPI number — DR. RICHARD JONES M D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
RICHARD
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M 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:
1023155223
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 W ARBROOK BLVD
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76014-3105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-717-2551
Provider Business Mailing Address Fax Number:
866-717-2551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W ARBROOK BLVD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76014-3105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-717-2551
Provider Business Practice Location Address Fax Number:
866-717-2551
Provider Enumeration Date:
01/30/2007

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: 2085R0202X , with the licence number:  5413741-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: M6682 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0202X , with the licence number: E-5324 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 166470001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200125920 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5413741-1205 . This is a "STATE LICENSE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 189281201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: E5324 . This is a "AR STATE LIC" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: M6682 . This is a "TX STATE LIC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 84627 . This is a "AR BCBS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 8AK783 . This is a "TX BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00462773 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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