Healthcare Provider Details

I. General information

NPI: 1457775603
Provider Name (Legal Business Name): JONES WELLNESS & CARDIOVASCULAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2014
Last Update Date: 02/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5640 READ BLVD SUITE 600
NEW ORLEANS LA
70127-3140
US

IV. Provider business mailing address

3717 LAKE TIMBERLANE DR
GRETNA LA
70056-8357
US

V. Phone/Fax

Practice location:
  • Phone: 504-662-3763
  • Fax:
Mailing address:
  • Phone: 504-258-1766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number13825R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number13825R
License Number StateLA

VIII. Authorized Official

Name: DR. MICHAEL BOZELLY JONES
Title or Position: OWNER/PHYSICAIN
Credential: M.D.
Phone: 504-655-3074