MEDICARE: DOLORES L. JONES PA

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	363A00000X	Physician Assistant	MA000472	PA

General Provider Information

NPI Number	:	1619917861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLORES L. JONES PA

Provider Business Mailing Address
First Line	:	1401 S 4TH ST
Second Line	:	4TH FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-5948
Country	:	US
Telephone Number	:	215-339-1079
Fax Number	:	215-952-6966

Provider Business Practice Location Address
First Line	:	432 N 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-4004
Country	:	US
Telephone Number	:	215-925-2400
Fax Number	:	215-925-9166

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	03/27/2014

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Directions to “ DOLORES L. JONES PA” Practice Location

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