Provider Demographics
NPI:1366692238
Name:JONES, JUDITH KAYE (PA-C)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:KAYE
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N PARK AVE
Mailing Address - Street 2:110
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-5034
Mailing Address - Country:US
Mailing Address - Phone:520-284-9200
Mailing Address - Fax:
Practice Address - Street 1:501 N PARK AVE
Practice Address - Street 2:110
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5034
Practice Address - Country:US
Practice Address - Phone:520-284-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085000908363AM0700X
AZ4956363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical