Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 56260 | AZ |
NPI | 1023363009 |
---|---|
Provider Name | Joshua Derren Jones |
First Address | Litchfield Park, AZ 85340-9481 |
Second Address | Litchfield Park, AZ 85340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2012 |
Last Update Date | 14/08/2018 |