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General NPI Number Information
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NPI Number | 1124284336
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Entity Type | Individual
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Provider Name | DANIEL FULLER JONES MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 11 E ATHENS AVE UNIT 308
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City | ARDMORE
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State | PA
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Zip | 19003
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Country | US
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Telephone | 802-734-8052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84
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City | NORWICH
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State | VT
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Zip | 05055-0084
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Country | US
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Telephone | 802-734-8052
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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 | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | 042.0011960
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD433643
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License Number State | PA
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