Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 17327 | WV |
NPI | 1497835466 |
---|---|
Provider Name | Dr. Evan A Jones |
First Address | Morgantown, WV 26507-0897 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 31/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0108562000 | (05) | WV |
F44808 | (02) |