Provider Demographics
NPI:1174506950
Name:JONES, JOHN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
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 1:2116 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2402
Mailing Address - Country:US
Mailing Address - Phone:757-825-4260
Mailing Address - Fax:757-825-4265
Practice Address - Street 1:2116 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2402
Practice Address - Country:US
Practice Address - Phone:757-825-4260
Practice Address - Fax:757-825-4265
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019881207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA060028OtherANTHEM BLUE CROSS
VA51106OtherOPTIMA
VA251266OtherCIGNA
VA006072810Medicaid
VA006072810Medicaid
VA251266OtherCIGNA