MEDICARE: JAMES RANDALL JONES PHYSICAL THERAPIST

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	225100000X	Physical Therapist	2536	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	245803201	OTHER	OK	MEDICARE CROSSOVER CLAIMS
5	245803201	OTHER	OK	MEDICARE MSP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	73159	OTHER	OK	KEMPTON CO./ FIRST HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538177142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RANDALL JONES PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	PO BOX 86
Second Line	:
City	:	CLINTON
State	:	OK
Zip	:	73601-0086
Country	:	US
Telephone Number	:	580-323-8778
Fax Number	:	866-490-4693

Provider Business Practice Location Address
First Line	:	509 S 30TH ST
Second Line	:
City	:	CLINTON
State	:	OK
Zip	:	73601-3632
Country	:	US
Telephone Number	:	580-323-8778
Fax Number	:	866-490-4693

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	03/02/2026

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Directions to “ JAMES RANDALL JONES PHYSICAL THERAPIST” Practice Location

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