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NPI Code Detail

MEDICARE: DR. BLAKE CHARLES JONES M.D.

MEDICARE: DR. BLAKE CHARLES 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
12085R0202XDiagnostic Radiology PhysicianT7961TX
22085R0202XDiagnostic Radiology PhysicianC0501KY
32085R0202XDiagnostic Radiology Physician2026-01740NC
42085R0202XDiagnostic Radiology PhysicianD80081MD
52085R0202XDiagnostic Radiology Physician70681WI

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 : 1518209766
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLAKE CHARLES JONES M.D.
Provider Business Mailing Address
First Line : 2825 OAK LAWN AVE UNIT 192749
Second Line :
City : DALLAS
State : TX
Zip : 75219-4688
Country : US
Telephone Number : 510-683-9500
Fax Number : 877-880-2039
Provider Business Practice Location Address
First Line : 2825 OAK LAWN AVE UNIT 192749
Second Line :
City : DALLAS
State : TX
Zip : 75219-4688
Country : US
Telephone Number : 510-683-9500
Fax Number : 877-880-2039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 04/07/2026

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