Healthcare Provider Details

I. General information

NPI: 1386733756
Provider Name (Legal Business Name): JULIE ANNE JONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE ANNE JONES M.D.

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3095 FENNO DR
CORDILLERA CO
81632-6090
US

IV. Provider business mailing address

3095 FENNO DR
CORDILLERA CO
81632-6090
US

V. Phone/Fax

Practice location:
  • Phone: 970-569-3839
  • Fax: 970-569-3839
Mailing address:
  • Phone: 970-569-3839
  • Fax: 970-569-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberF4127
License Number StateTX

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: