Provider Demographics
NPI:1295028561
Name:JONES, STACY K (MD)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S. SANTE FE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-452-7269
Mailing Address - Fax:785-452-6008
Practice Address - Street 1:501 S. SANTE FE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-452-7245
Practice Address - Fax:785-452-7246
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0438988208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201135830AMedicaid