Provider Demographics
NPI:1053317388
Name:JONES, SCOTT D (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 ROSEDALE CT
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-2637
Mailing Address - Country:US
Mailing Address - Phone:314-544-7961
Mailing Address - Fax:
Practice Address - Street 1:2028 ROSEDALE CT
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-2637
Practice Address - Country:US
Practice Address - Phone:314-544-7961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL568230OtherHEALTHLINK
IL900068033OtherTAX-ID#
ILP00110684OtherMEDICARE RAILROAD
IL08220357OtherBCBS GRP#
IL568230OtherHEALTHLINK
IL207465Medicare PIN