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NPI Code Detail

MEDICARE: MARY JONES

MEDICARE:   MARY  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
1235Z00000XSpeech-Language Pathologist22005338AIN

General Provider Information

NPI Number : 1912419086
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JONES
Provider Business Mailing Address
First Line : 1411 W COUNTY LINE RD STE A
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-5250
Country : US
Telephone Number : 800-486-4449
Fax Number :
Provider Business Practice Location Address
First Line : 2030 CHESTER BLVD
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1215
Country : US
Telephone Number : 765-962-4663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2017
Last Update Date : 10/30/2017

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Directions to “ MARY JONES ” Practice Location

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