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NPI Code Detail

MEDICARE: DR. RANDY JONES MD

MEDICARE: DR. RANDY 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
1207P00000XEmergency Medicine Physician35-078906OH

Other Identifiers

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

General Provider Information

NPI Number : 1104824002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDY JONES MD
Provider Business Mailing Address
First Line : 1320 W MAIN ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-1822
Country : US
Telephone Number : 220-564-4151
Fax Number : 220-564-7153
Provider Business Practice Location Address
First Line : 1320 W MAIN ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-1822
Country : US
Telephone Number : 220-564-4151
Fax Number : 220-564-7153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 09/13/2016

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Directions to “ DR. RANDY JONES MD” Practice Location

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