MEDICARE: RUTH DIANE JONES D.O.

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	207Q00000X	Family Medicine Physician	OS009365-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000416293	OTHER	PA	HIGHMARK BC BS

General Provider Information

NPI Number	:	1750420303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH DIANE JONES D.O.

Provider Business Mailing Address
First Line	:	342 S RICHARD ST
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-1743
Country	:	US
Telephone Number	:	814-623-8414
Fax Number	:	814-623-6668

Provider Business Practice Location Address
First Line	:	9528 LINCOLN HIGHWAY
Second Line	:	SUITE 1
City	:	BEDFORD
State	:	PA
Zip	:	15522-3764
Country	:	US
Telephone Number	:	814-510-3409
Fax Number	:	814-510-3410

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	02/27/2023

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