MEDICARE: MARCUS D 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
1	251E00000X	Home Health Agency	51483601	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982369260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS D JONES

Provider Business Mailing Address
First Line	:	1039 WAGNER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-2927
Country	:	US
Telephone Number	:	267-596-5857
Fax Number	:

Provider Business Practice Location Address
First Line	:	1039 WAGNER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-2927
Country	:	US
Telephone Number	:	267-596-5857
Fax Number	:

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

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	11/08/2021

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Directions to “ MARCUS D JONES ” Practice Location

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