MEDICARE: PATRICK DAVID 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	363AM0700X	Medical Physician Assistant
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1801307202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK DAVID JONES PA-C

Provider Business Mailing Address
First Line	:	72ND MEDICAL GROUP, 7050 AIR DEPOT BLVD STE 1094
Second Line	:
City	:	TINKER AFB
State	:	OK
Zip	:	73145-8716
Country	:	US
Telephone Number	:	405-734-2778
Fax Number	:

Provider Business Practice Location Address
First Line	:	72ND MEDICAL GROUP, 7050 AIR DEPOT BLVD STE 1094
Second Line	:
City	:	TINKER AFB
State	:	OK
Zip	:	73145-8716
Country	:	US
Telephone Number	:	405-734-2778
Fax Number	:

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

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	02/04/2026

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