Provider Demographics
NPI:1225720873
Name:JONES, DAPHNEE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DAPHNEE
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7147 COUNTY ROAD 1600
Mailing Address - Street 2:
Mailing Address - City:ROFF
Mailing Address - State:OK
Mailing Address - Zip Code:74865-6143
Mailing Address - Country:US
Mailing Address - Phone:501-206-9123
Mailing Address - Fax:
Practice Address - Street 1:1104 WALNUT DR
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2353
Practice Address - Country:US
Practice Address - Phone:580-226-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5021363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant