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NPI Code Detail

MEDICARE: DR. ELLY JO JONES DMD

MEDICARE: DR. ELLY JO JONES DMD
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
1122300000XDentist8508KY

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 : 1770787467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLY JO JONES DMD
Provider Business Mailing Address
First Line : 1010 MAIN ST S
Second Line :
City : MC KEE
State : KY
Zip : 40447-7089
Country : US
Telephone Number : 606-287-7104
Fax Number : 606-287-4409
Provider Business Practice Location Address
First Line : 1010 MAIN ST S
Second Line :
City : MC KEE
State : KY
Zip : 40447-7089
Country : US
Telephone Number : 606-287-7104
Fax Number : 606-287-4409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 08/19/2010

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Directions to “ DR. ELLY JO JONES DMD” Practice Location

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