MEDICARE: AMANDA GALE 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1730897273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GALE JONES

Provider Business Mailing Address
First Line	:	520 JANE ST # A
Second Line	:
City	:	ALMA
State	:	AR
Zip	:	72921-8574
Country	:	US
Telephone Number	:	479-462-6385
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 GRAND AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72904-6945
Country	:	US
Telephone Number	:	479-462-6385
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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Directions to “ AMANDA GALE JONES ” Practice Location

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