MEDICARE: DR. STEPHANIE JONES D.O.

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	2086S0120X	Pediatric Surgery Physician	DO2170	NV
2	2086S0120X	Pediatric Surgery Physician	A11813	CA

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	:	1184777120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE JONES D.O.

Provider Business Mailing Address
First Line	:	3016 W CHARLESTON BLVD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1963
Country	:	US
Telephone Number	:	702-780-2312
Fax Number	:	702-895-4014

Provider Business Practice Location Address
First Line	:	3121 S MARYLAND PKWY STE 400
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2309
Country	:	US
Telephone Number	:	702-250-2500
Fax Number	:	702-250-2220

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	01/08/2020

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