Provider Demographics
NPI:1356447858
Name:JONES, WHITNEY (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 TERRA CROSSING BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5371
Mailing Address - Country:US
Mailing Address - Phone:502-888-1988
Mailing Address - Fax:877-393-6284
Practice Address - Street 1:2401 TERRA CROSSING BLVD STE 410
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5371
Practice Address - Country:US
Practice Address - Phone:502-888-1988
Practice Address - Fax:877-393-6284
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30853207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01129727Medicare PIN
E13729Medicare UPIN
KYK066600Medicare Oscar/Certification