=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073525200
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY ANN MEYER JONES M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2006
-----------------------------------------------------
Last Update Date | 07/10/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2022 KELLE DR
-----------------------------------------------------
City | CHESTERTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46304-8708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-462-0909
-----------------------------------------------------
Fax | 219-462-9910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2022 KELLE DR
-----------------------------------------------------
City | CHESTERTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46304-8708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-462-0909
-----------------------------------------------------
Fax | 219-462-9910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 01046381A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------