1497720486 NPI number — DR. JANE LYNDALL JONES MD

Table of content: DR. JANE LYNDALL JONES MD (NPI 1497720486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497720486 NPI number — DR. JANE LYNDALL JONES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
JANE
Provider Middle Name:
LYNDALL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
LYNDY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1497720486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4450 S RURAL RD
Provider Second Line Business Mailing Address:
C-216
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85282-7037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-820-3188
Provider Business Mailing Address Fax Number:
480-838-5033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4450 S RURAL RD
Provider Second Line Business Practice Location Address:
C-216
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85282-7037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-820-3188
Provider Business Practice Location Address Fax Number:
480-838-5033
Provider Enumeration Date:
02/22/2006

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: 208000000X , with the licence number:  19096 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5926009 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 84334 . This is a "PACIFICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2780450 . This is a "AHCCCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: AZ0867040 . This is a "BLUE CROSS OF AZ" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 27780450 . This is a "PHOENIX HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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