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NPI Code Detail

MEDICARE: DR. KATHLEEN MARY JONES M.D.

MEDICARE: DR. KATHLEEN MARY JONES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician30291AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12Z1708OTHERAZHEALTHNET
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3AZ0769190OTHERAZBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1093793150
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN MARY JONES M.D.
Provider Business Mailing Address
First Line : 101 COLE AVE
Second Line :
City : BISBEE
State : AZ
Zip : 85603-1327
Country : US
Telephone Number : 520-432-2042
Fax Number :
Provider Business Practice Location Address
First Line : 101 COLE AVE
Second Line :
City : BISBEE
State : AZ
Zip : 85603-1327
Country : US
Telephone Number : 520-432-2042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2006
Last Update Date : 06/03/2011

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