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NPI Code Detail

MEDICARE: DOMINIQUE L JONES MD

MEDICARE:   DOMINIQUE L JONES  MD
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
13747P1801XPersonal Care AttendantMD
23747P1801XPersonal Care Attendant20284MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215580139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE L JONES MD
Provider Business Mailing Address
First Line : 3323 PUMPHREY DR
Second Line :
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-4308
Country : US
Telephone Number : 202-848-0801
Fax Number :
Provider Business Practice Location Address
First Line : 3323 PUMPHREY DR
Second Line :
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-4308
Country : US
Telephone Number : 202-848-0801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2019
Last Update Date : 07/19/2019

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