Provider Demographics
NPI:1275592024
Name:JONES, JOHN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 E A ST
Mailing Address - Street 2:STE 101
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2276
Mailing Address - Country:US
Mailing Address - Phone:307-577-8600
Mailing Address - Fax:307-577-8605
Practice Address - Street 1:1416 E A ST
Practice Address - Street 2:STE 101
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2276
Practice Address - Country:US
Practice Address - Phone:307-577-8600
Practice Address - Fax:307-577-8605
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5480A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1096621 00Medicaid
WY340008695OtherMEDICARE RAILROAD
WYW306655Medicare PIN
WYF39314Medicare UPIN