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NPI Code Detail

MEDICARE: MAKENZIE JONES

MEDICARE: MAKENZIE JONES
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
1224Z00000XOccupational Therapy AssistantOT -A1147AR

General Provider Information

NPI Number : 1194275651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENZIE JONES
Provider Business Mailing Address
First Line : 906 E MATTHEWS AVE
Second Line :
City : JONESBORO
State : AR
Zip : 72401-3050
Country : US
Telephone Number : 870-919-0274
Fax Number : 870-277-4335
Provider Business Practice Location Address
First Line : 2911 LONGVIEW DR STE B
Second Line :
City : JONESBORO
State : AR
Zip : 72401-5902
Country : US
Telephone Number : 870-336-0238
Fax Number : 870-336-0239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2016
Last Update Date : 02/26/2024

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