MEDICARE: AMY KEEBLER JONES MD

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	208000000X	Pediatrics Physician	35.080432	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043259534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY KEEBLER JONES MD

Provider Business Mailing Address
First Line	:	6251 GOOD SAMARITAN WAY
Second Line	:	SUITE 210C
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-5253
Country	:	US
Telephone Number	:	937-233-3910
Fax Number	:	937-233-8389

Provider Business Practice Location Address
First Line	:	6251 GOOD SAMARITAN WAY
Second Line	:	SUITE 210C
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-5253
Country	:	US
Telephone Number	:	937-233-3910
Fax Number	:	937-233-8389

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	11/14/2013

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