Provider Demographics
NPI:1073559407
Name:JONES, HARRIETT N (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRIETT
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:2117 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2408
Practice Address - Country:US
Practice Address - Phone:757-825-4273
Practice Address - Fax:757-825-4276
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
090664OtherBCBS
090664OtherHEALTHKEEPERS
41145OtherSEATANA
VA5644135Medicaid
264180OtherMAMSI
541559097OtherCHAMPUS
C36739Medicare UPIN
VA080002989Medicare ID - Type Unspecified