Provider Demographics
NPI:1164773859
Name:JONES, LARRY RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:RICHARD
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 N CAPITOL AVE
Mailing Address - Street 2:E400A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1218
Mailing Address - Country:US
Mailing Address - Phone:317-962-0095
Mailing Address - Fax:317-962-8259
Practice Address - Street 1:1800 N CAPITOL AVE
Practice Address - Street 2:E400A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1218
Practice Address - Country:US
Practice Address - Phone:317-962-0095
Practice Address - Fax:317-962-8259
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01026268A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice