MEDICARE: JOHN JONES

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1609536465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JONES

Provider Business Mailing Address
First Line	:	6611 E MAYO BLVD UNIT 3136
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-4523
Country	:	US
Telephone Number	:	520-442-8935
Fax Number	:

Provider Business Practice Location Address
First Line	:	6611 E MAYO BLVD UNIT 3136
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-4523
Country	:	US
Telephone Number	:	520-442-8935
Fax Number	:

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

Provider Enumeration Date	:	12/21/2021
Last Update Date	:	12/21/2021

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Directions to “ JOHN JONES ” Practice Location

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