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NPI Code Detail

MEDICARE: JOE JONES BSW

MEDICARE: JOE JONES BSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1932459575
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOE JONES BSW
Provider Business Mailing Address
First Line : 700 2ND ST NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-1578
Country : US
Telephone Number : 505-884-4464
Fax Number : 505-884-0054
Provider Business Practice Location Address
First Line : 700 2ND ST NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-1578
Country : US
Telephone Number : 505-884-4464
Fax Number : 505-884-0054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2012
Last Update Date : 09/11/2012

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