Healthcare Provider Details

I. General information

NPI: 1316949662
Provider Name (Legal Business Name): DAVID R. JONES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SAINT ALBANS CIRCLE SUITE C
NEWTOWN SQUARE PA
19073-3619
US

IV. Provider business mailing address

13 SAINT ALBANS CIRCLE SUITE C
NEWTOWN SQUARE PA
19073-3619
US

V. Phone/Fax

Practice location:
  • Phone: 610-853-2900
  • Fax: 610-853-2980
Mailing address:
  • Phone: 484-422-8647
  • Fax: 484-422-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS008904L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: