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NPI Code Detail

MEDICARE: MR. THOMAS JONES RPA C

MEDICARE: MR. THOMAS JONES RPA 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
1364SF0001XFamily Health Clinical Nurse Specialist0067981NY
2363A00000XPhysician Assistant5601003728MI

General Provider Information

NPI Number : 1598700593
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS JONES RPA C
Provider Business Mailing Address
First Line : 3304 COOLEY CT
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7430
Country : US
Telephone Number : 269-349-2266
Fax Number : 269-349-0792
Provider Business Practice Location Address
First Line : 3304 COOLEY CT
Second Line :
City : PORTAGE
State : MI
Zip : 49024-7430
Country : US
Telephone Number : 269-349-2266
Fax Number : 269-349-0792
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2006
Last Update Date : 12/11/2007

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