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General NPI Number Information
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NPI Number | 1558434795
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Entity Type | Individual
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Provider Name | DAVID ROY JONES PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 305 W JACKSON ST STE 206
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City | CARBONDALE
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State | IL
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Zip | 62901-1474
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Country | US
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Telephone | 618-457-3006
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Fax | 618-457-3007
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Provider Business Mailing Address
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Address Line | PO BOX 3988 1239 E MAIN STREET
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City | CARBONDALE
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State | IL
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Zip | 62901
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Country | US
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Telephone | 618-457-5200
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 085-001642
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2023019428
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-001642
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License Number State | IL
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