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General NPI Number Information
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NPI Number | 1760685507
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Entity Type | Organization
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Legal Business Name | JONES FAMILY PRACTICE
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 810 HIGH ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-3101
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Country | US
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Telephone | 785-594-6412
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Fax | 785-594-3599
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Provider Business Mailing Address
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Address Line | 810 HIGH ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-3101
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Country | US
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Telephone | 785-594-6412
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Fax | 785-594-3599
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Authorized Official
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Title or Position | OWNER
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Name | RAY MANDEVILLE JONES JR.
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Credential | DO
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Telephone | 785-594-6412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 05-12996
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License Number State | KS
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