Provider Demographics
NPI:1114061843
Name:JONES, JOSEPH SHAW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SHAW
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W COLONIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-9002
Mailing Address - Country:US
Mailing Address - Phone:703-662-3090
Mailing Address - Fax:703-267-6977
Practice Address - Street 1:11230 WAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-246-9355
Practice Address - Fax:703-267-6977
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044170207RA0401X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFJ0028212OtherDEA