Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 256844 | MA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 31852 | OK |
N | 208200000X | Surgeon | 35099577 | OH |
N | 208600000X | Surgeon | 35099577 | OH |
N | 208200000X | Surgeon | R4P52 | MO |
N | 208600000X | Surgeon | R4P52 | MO |
NPI | 1063424331 |
---|---|
Provider Name | Timothy R. Jones |
First Address | Malvern, PA 19355-0746 |
Second Address | Enid, OK 73701-5863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113393 | BC/BS PROVIDER NUMBER (01) | MO |
142569 | HEALTHLINK PROVIDER NUMBE (01) | MO |
2759638 | CIGNA PROVIDER NUMBER (01) | MO |
4206783 | AETNA PROVIDER NUMBER (01) | MO |
E89354 | (02) |