MEDICARE: MR. TIMOTHY ALLEN JONES CRNA, DNS

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	367500000X	Certified Registered Nurse Anesthetist	627147	TX

General Provider Information

NPI Number	:	1396746152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY ALLEN JONES CRNA, DNS

Provider Business Mailing Address
First Line	:	1809 ARROYA RD
Second Line	:
City	:	DALHART
State	:	TX
Zip	:	79022-4805
Country	:	US
Telephone Number	:	806-333-0629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 ARROYA RD
Second Line	:
City	:	DALHART
State	:	TX
Zip	:	79022-4805
Country	:	US
Telephone Number	:	806-333-0629
Fax Number	:

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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