Healthcare Provider Details

I. General information

NPI: 1356502785
Provider Name (Legal Business Name): JEFFREY L JONES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 6TH ST
DUNBAR WV
25064-3204
US

IV. Provider business mailing address

615 ELSINORE PL STE 200
CINCINNATI OH
45202-1457
US

V. Phone/Fax

Practice location:
  • Phone: 304-415-3129
  • Fax: 304-212-7801
Mailing address:
  • Phone: 513-834-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number01401
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: