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NPI Code Detail

MEDICARE: DR. BOBBY WAYNE JONES DC

MEDICARE:  DR. BOBBY WAYNE JONES  DC
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
1111N00000XChiropractor3597OR

General Provider Information

NPI Number : 1861484412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BOBBY WAYNE JONES DC
Provider Business Mailing Address
First Line : 4425 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4260
Country : US
Telephone Number : 503-227-8700
Fax Number : 503-227-8702
Provider Business Practice Location Address
First Line : 4425 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4260
Country : US
Telephone Number : 503-227-8700
Fax Number : 503-227-8702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 01/06/2009

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Directions to “ DR. BOBBY WAYNE JONES DC” Practice Location

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