1346272028 NPI number — JOE D JONES D.C.

Table of content: JOE D JONES D.C. (NPI 1346272028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346272028 NPI number — JOE D JONES D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
JOE
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1346272028
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
413 CHEROKEE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEAVENWORTH
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66048-2717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-651-2500
Provider Business Mailing Address Fax Number:
913-651-2520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
413 CHEROKEE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAVENWORTH
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66048-2717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-651-2500
Provider Business Practice Location Address Fax Number:
913-651-2520
Provider Enumeration Date:
07/06/2006

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: 111NI0900X , with the licence number:  01-04846 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111NI0900X , with the licence number: 2003032014 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 062044 . This is a "BLUE CROSS BLUE SHIELD PR" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 660059 . This is a "BLUE CROSS BLUE SHIELD GR" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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