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NPI Code Detail

MEDICARE: TRACY LYNN JONS PA-C

MEDICARE:   TRACY LYNN JONS  PA-C
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
1363AM0700XMedical Physician Assistant374WY

General Provider Information

NPI Number : 1588614895
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY LYNN JONS PA-C
Provider Business Mailing Address
First Line : 618 APACHE DR
Second Line :
City : BUFFALO
State : WY
Zip : 82834-2514
Country : US
Telephone Number : 307-684-7339
Fax Number :
Provider Business Practice Location Address
First Line : 1333 W 5TH ST
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-2752
Country : US
Telephone Number : 307-672-2522
Fax Number : 307-672-3732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/25/2007

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Directions to “ TRACY LYNN JONS PA-C” Practice Location

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