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General NPI Number Information
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NPI Number | 1073489332
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Entity Type | Individual
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Provider Name | MIA R JONES
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2220 NW 164TH ST
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City | EDMOND
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State | OK
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Zip | 73013-8801
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Country | US
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Telephone | 405-757-7980
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Fax |
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Provider Business Mailing Address
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Address Line | 128 FORREST LN
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City | CLINTON
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State | OK
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Zip | 73601-4936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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