MEDICARE: RICHARD E JONES D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0000X	Sports Medicine Podiatrist	N004241-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	141824381	OTHER	NY	TAX ID#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043238181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD E JONES D.P.M.

Provider Business Mailing Address
First Line	:	119 LAWRENCE STREET
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866
Country	:	US
Telephone Number	:	518-584-7361
Fax Number	:	518-584-7930

Provider Business Practice Location Address
First Line	:	119 LAWRENCE ST
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1346
Country	:	US
Telephone Number	:	518-584-7361
Fax Number	:	518-584-7930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	09/25/2014

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