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NPI Code Detail

MEDICARE: TRISSAN JONES AU.D.

MEDICARE: TRISSAN JONES AU.D.
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
1231H00000XAudiologistDA8956AZ

General Provider Information

NPI Number : 1518376276
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISSAN JONES AU.D.
Provider Business Mailing Address
First Line : 1935 W HAYWARD AVE
Second Line : OFFICE F-4
City : PHOENIX
State : AZ
Zip : 85021-6921
Country : US
Telephone Number : 602-771-4431
Fax Number :
Provider Business Practice Location Address
First Line : 1935 W HAYWARD AVE
Second Line : OFFICE F-4
City : PHOENIX
State : AZ
Zip : 85021-6921
Country : US
Telephone Number : 602-771-4431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2014
Last Update Date : 08/07/2014

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