Provider Demographics
NPI:1386646255
Name:JONES, HUDSON VALENTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:HUDSON
Middle Name:VALENTINE
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:PO BOX 4664
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43610-0664
Mailing Address - Country:US
Mailing Address - Phone:419-241-2882
Mailing Address - Fax:419-241-2883
Practice Address - Street 1:620 W BANCROFT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1606
Practice Address - Country:US
Practice Address - Phone:419-241-2882
Practice Address - Fax:419-241-2883
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045977207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0513724Medicaid
C02489Medicare UPIN
J00527901Medicare ID - Type Unspecified