Healthcare Provider Details

I. General information

NPI: 1205665619
Provider Name (Legal Business Name): TEAM JONES MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 W DAUBER DR
OTTAWA HILLS OH
43615-2172
US

IV. Provider business mailing address

PO BOX 353005
TOLEDO OH
43635-3005
US

V. Phone/Fax

Practice location:
  • Phone: 419-764-4448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES JONES
Title or Position: CO-OWNER
Credential:
Phone: 419-764-4448