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NPI Code Detail

MEDICARE: DR. JAY T JONES MD

MEDICARE: DR. JAY T JONES MD
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
12085R0202XDiagnostic Radiology Physician0101236170VA
22085R0202XDiagnostic Radiology Physician01063734AIN
32085R0202XDiagnostic Radiology Physician35 125043OH

General Provider Information

NPI Number : 1902870033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY T JONES MD
Provider Business Mailing Address
First Line : 4530 DENALI CV
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-9117
Country : US
Telephone Number : 812-374-9344
Fax Number :
Provider Business Practice Location Address
First Line : 3707 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1702
Country : US
Telephone Number : 260-469-4763
Fax Number : 260-484-5919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 01/28/2016

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