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General NPI Number Information
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NPI Number | 1689907131
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Entity Type | Organization
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Legal Business Name | JOE V. JONES MD, PA.
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 12/29/2009
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Provider Practice Location Address
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Address Line | 605 N 2ND ST BLYTHEVILLE
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2034
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Country | US
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Telephone | 870-763-1520
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Fax | 870-762-2370
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Provider Business Mailing Address
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Address Line | 605 N 2ND ST BLYTHEVILLE
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2034
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Country | US
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Telephone | 870-763-1520
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Fax | 870-762-2370
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Authorized Official
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Title or Position | PRIMARY DOCTOR/ OWNER
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Name | DR. JOE V. JONES
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Credential | MD, PA
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Telephone | 870-763-1520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A01707 ANP
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | N-5634
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License Number State | AR
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