MEDICARE: TIM 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
1	174400000X	Specialist	5045	OH

General Provider Information

NPI Number	:	1265985352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIM JONES

Provider Business Mailing Address
First Line	:	1527 EASTMEADOW PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-7535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 EASTMEADOW PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-7535
Country	:	US
Telephone Number	:	614-209-5825
Fax Number	:

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

Provider Enumeration Date	:	07/26/2016
Last Update Date	:	07/26/2016

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Directions to “ TIM JONES ” Practice Location

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