Provider Demographics
NPI:1235101676
Name:JONES, HORATIO C III (MD)
Entity Type:Individual
Prefix:DR
First Name:HORATIO
Middle Name:C
Last Name:JONES
Suffix:III
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 1:5311 LIMESTONE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808
Mailing Address - Country:US
Mailing Address - Phone:302-224-9109
Mailing Address - Fax:302-234-9042
Practice Address - Street 1:5311 LIMESTONE RD
Practice Address - Street 2:STE 201
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-224-9109
Practice Address - Fax:302-234-9042
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI0005740208D00000X
DEC10005740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
00421053Medicare ID - Type Unspecified
H05131Medicare UPIN