Provider Demographics
NPI:1326037409
Name:KATHRYN B JONES MD PSC
Entity Type:Organization
Organization Name:KATHRYN B JONES MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:BRAY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-744-5757
Mailing Address - Street 1:1109 MCCANN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1178
Mailing Address - Country:US
Mailing Address - Phone:859-744-5757
Mailing Address - Fax:859-744-5535
Practice Address - Street 1:1109 MCCANN DR
Practice Address - Street 2:SUITE 1
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1178
Practice Address - Country:US
Practice Address - Phone:859-744-5757
Practice Address - Fax:859-744-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34911207R00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001643Medicaid
KY183919Medicare ID - Type UnspecifiedRGBA
KY35001643Medicaid
0726101Medicare ID - Type Unspecified