=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912218801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAUL O JONES JR MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2010
-----------------------------------------------------
Last Update Date | 08/05/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 599 9TH ST N STE 307
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-325-4804
-----------------------------------------------------
Fax | 239-325-4800
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 599 9TH ST N STE 307
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-325-4804
-----------------------------------------------------
Fax | 239-325-4800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. PAUL O JONES JR.
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 239-325-4804
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 173000000X
-----------------------------------------------------
Taxonomy Name | Legal Medicine
-----------------------------------------------------
License Number | ME54146
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------