Provider Demographics
NPI:1043238181
Name:JONES, RICHARD E (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LAWRENCE STREET
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:518-584-7361
Mailing Address - Fax:518-584-7930
Practice Address - Street 1:119 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1346
Practice Address - Country:US
Practice Address - Phone:518-584-7361
Practice Address - Fax:518-584-7930
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004241-1213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141824381OtherTAX ID#
NY03189519Medicaid
NYT11615Medicare UPIN
NY03189519Medicaid