MEDICARE: DR. JERRY L 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	207V00000X	Obstetrics & Gynecology Physician	4676	NV

General Provider Information

NPI Number	:	1356413561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY L JONES MD

Provider Business Mailing Address
First Line	:	PO BOX 370861
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89137-0861
Country	:	US
Telephone Number	:	702-384-5400
Fax Number	:	702-384-0648

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 317
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0504
Country	:	US
Telephone Number	:	702-384-5400
Fax Number	:	702-384-0648

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/09/2022

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