Provider Demographics
NPI:1003894403
Name:JONES, STANLEY G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:G
Last Name:JONES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:1012 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5044
Practice Address - Country:US
Practice Address - Phone:573-431-0330
Practice Address - Fax:573-472-2966
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2021-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOMDR7C09207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO21183OtherBCBS MO NUMBER
MO238544OtherHEALTHLINK NUMBER
MO43074141063801A072OtherTRICARE NUMBER
MO430741410OtherFIRST HEALTH NUMBER
MO202245403Medicaid