Provider Demographics
NPI:1194816272
Name:JONES, JEFFRY HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:JEFFRY
Middle Name:HOWARD
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:PO BOX 19784
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-0784
Mailing Address - Country:US
Mailing Address - Phone:916-925-2096
Mailing Address - Fax:916-925-1144
Practice Address - Street 1:500 UNIVERSITY AVENUE
Practice Address - Street 2:SUITE 260
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-925-2096
Practice Address - Fax:916-925-1144
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81725207RC0200X, 207RP1001X, 207RI0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G817250Medicaid
CA00G817250Medicaid
CA00G817250Medicare PIN