MEDICARE: JONATHAN SCOTT JONES 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
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1699003178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SCOTT JONES PA-C

Provider Business Mailing Address
First Line	:	1715 N WEBER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 N WEBER ST STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7524
Country	:	US
Telephone Number	:	719-635-8885
Fax Number	:

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

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	02/28/2024

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