Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 37717 | MN |
N | 207Q00000X | Family Doctor | G88179 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 17667 | HI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 43404 | AZ |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | M-12862 | ID |
NPI | 1730327966 |
---|---|
Provider Name | Dr. Leah Jones |
First Address | Tucson, AZ 85704-6313 |
Second Address | Tucson, AZ 85704-6313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2009 |
Last Update Date | 27/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35721290 | MEDICAL ASSISTANCE (01) | MN |
F95817 | (02) | MN |