Provider Demographics
NPI:1134136401
Name:JONES, KATHRYN B (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:B
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 1:1109 MCCANN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1178
Mailing Address - Country:US
Mailing Address - Phone:859-744-5757
Mailing Address - Fax:859-744-5535
Practice Address - Street 1:1109 MCCANN DR
Practice Address - Street 2:SUITE 1
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1178
Practice Address - Country:US
Practice Address - Phone:859-744-5757
Practice Address - Fax:859-744-5535
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34911207R00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY183919OtherRIVERBEND GOVERNMENT
KY35001643Medicaid
KY64048275Medicaid
KY0726101Medicare PIN
KY64048275Medicaid