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General NPI Number Information
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NPI Number | 1326410788
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Entity Type | Organization
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Legal Business Name | ROBERTA L. JONES
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 322 CRESTWOOD AVE
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City | AKRON
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State | OH
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Zip | 44302-1619
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Country | US
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Telephone | 330-247-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 322 CRESTWOOD AVE
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City | AKRON
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State | OH
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Zip | 44302-1619
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Country | US
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Telephone | 330-247-8400
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | ROBERTA L. JONES
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Credential |
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Telephone | 330-247-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 2864324
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License Number State | OH
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