MEDICARE: RONALD G 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	16852	TN
2	208000000X	Pediatrics Physician	2009-00528	NC
3	208000000X	Pediatrics Physician	047463	GA
4	208000000X	Pediatrics Physician	2011021428	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	152NT	OTHER	NC	BCBSNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134193642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD G JONES MD

Provider Business Mailing Address
First Line	:	PO BOX 2580
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65801-2580
Country	:	US
Telephone Number	:	417-829-4620
Fax Number	:	417-829-4316

Provider Business Practice Location Address
First Line	:	2115 S FREMONT AVE
Second Line	:	STE 2900
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2239
Country	:	US
Telephone Number	:	417-820-3535
Fax Number	:	417-820-3540

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	09/07/2011

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