Provider Demographics
NPI:1346272028
Name:JONES, JOE D (DC)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-2717
Mailing Address - Country:US
Mailing Address - Phone:913-651-2500
Mailing Address - Fax:913-651-2520
Practice Address - Street 1:413 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-2717
Practice Address - Country:US
Practice Address - Phone:913-651-2500
Practice Address - Fax:913-651-2520
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04846111NI0900X
MO2003032014111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062044OtherBLUE CROSS BLUE SHIELD PR
KS660059OtherBLUE CROSS BLUE SHIELD GR
KS062044OtherBLUE CROSS BLUE SHIELD PR
KS062044Medicare ID - Type Unspecified