Healthcare Provider Details

I. General information

NPI: 1104742063
Provider Name (Legal Business Name): ROBERT DARRELL JONES M.ED., CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 CENTRAL RD
LEXINGTON VA
24450-2700
US

IV. Provider business mailing address

85 CENTRAL RD
LEXINGTON VA
24450-2700
US

V. Phone/Fax

Practice location:
  • Phone: 540-463-4500
  • Fax: 540-463-2225
Mailing address:
  • Phone: 540-463-4500
  • Fax: 540-463-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202002940
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: