Provider Demographics
NPI:1356317952
Name:JONES, DWAYNE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2790 CLAY EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3276
Mailing Address - Country:US
Mailing Address - Phone:913-322-6370
Mailing Address - Fax:913-381-0979
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:913-642-4900
Practice Address - Fax:913-381-0979
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO109157207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208129460Medicaid
MOP00226192OtherRR MEDICARE
MOP00226192OtherRR MEDICARE