Provider Demographics
NPI:1205011574
Name:SANDRA JONES WU MD INC
Entity Type:Organization
Organization Name:SANDRA JONES WU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-459-5227
Mailing Address - Street 1:1194 OLD HENDERSON RD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3694
Mailing Address - Country:US
Mailing Address - Phone:614-459-5227
Mailing Address - Fax:614-459-5681
Practice Address - Street 1:1194 OLD HENDERSON RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3694
Practice Address - Country:US
Practice Address - Phone:614-459-5227
Practice Address - Fax:614-459-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000379020OtherANTHEM BC/BS
OH294445529007OtherMEDICAL MUTUAL
OH000000379020OtherANTHEM BC/BS