MEDICARE: PATRICIA MICHELLE JONES

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
1	1744P3200X	Prosthetics Case Management	332BC3200X	OH
2	1744P3200X	Prosthetics Case Management	335E00000X	OH

General Provider Information

NPI Number	:	1114515525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MICHELLE JONES

Provider Business Mailing Address
First Line	:	5313 GLOBE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1539
Country	:	US
Telephone Number	:	513-427-5294
Fax Number	:	513-434-6331

Provider Business Practice Location Address
First Line	:	5313 GLOBE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1539
Country	:	US
Telephone Number	:	513-427-5294
Fax Number	:	513-434-6331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2021
Last Update Date	:	07/02/2021

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