=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013943182
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FREDERICK MICHAEL JONES MA, CCC-A
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5500 ARMSTRONG RD VA MEDICAL CENTER (115A)
-----------------------------------------------------
City | BATTLE CREEK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-966-5600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3322 B DR S
-----------------------------------------------------
City | EAST LEROY
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49051-9741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-979-4870
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | APPLYING
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------