MEDICARE: RUSSELL L JONES D C CHIROPRACTIC CORPORATION

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	111N00000X	Chiropractor	561	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1023091238	OTHER	WV	R L JONES NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1073797379	OTHER	WV	NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1073596284	OTHER	WV	J S MORRIS NPI

General Provider Information

NPI Number	:	1598866857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSSELL L JONES D C CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	100 WESTMORELAND OFFICE PARK
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-2725
Country	:	US
Telephone Number	:	304-768-5068
Fax Number	:	304-768-6251

Provider Business Practice Location Address
First Line	:	100 WESTMORELAND OFFICE PARK
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-2725
Country	:	US
Telephone Number	:	304-768-5068
Fax Number	:	304-768-6251

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	TERESA WITHROW
Credential	:
Telephone Number	:	304-768-5068

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/07/2013

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1023091238 — RUSSELL L JONES D.C.
Practice Location Address:

100 WESTMORELAND OFFICE CENTER
DUNBAR, WV
25064-2725

Practice Phone: 304-768-5068
Practice Fax: 304-768-6251

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1093702219 — KCI USA, INC.
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Directions to “RUSSELL L JONES D C CHIROPRACTIC CORPORATION ” Practice Location

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