Provider Demographics
NPI:1194829598
Name:JONES, WILLIAM A (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
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 1:1302 SOUTH SHIELDS ST
Mailing Address - Street 2:SUITE A2-1
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4803
Mailing Address - Country:US
Mailing Address - Phone:970-493-3040
Mailing Address - Fax:970-493-3045
Practice Address - Street 1:1302 SOUTH SHIELDS ST
Practice Address - Street 2:SUITE A2-1
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4803
Practice Address - Country:US
Practice Address - Phone:970-493-3040
Practice Address - Fax:970-493-3045
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO163672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
016852OtherVALUE OPTIONS
252319OtherANTHEM
252319OtherANTHEM
COC47241Medicare ID - Type Unspecified