Provider Demographics
NPI:1386665719
Name:JONES, THOMAS P (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
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 1:23625 COMMERCE PARK
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5845
Mailing Address - Country:US
Mailing Address - Phone:216-255-5700
Mailing Address - Fax:866-898-2159
Practice Address - Street 1:2491 MISSION HILL DRIVE
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-6233
Practice Address - Country:US
Practice Address - Phone:419-874-9813
Practice Address - Fax:866-898-2159
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082457J2085R0202X
OH350824572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2421918Medicaid
AZP00971382OtherRXR MEDICARE
OH4104717Medicare PIN
OHG88603Medicare UPIN
OHJO4104711Medicare PIN
AZZ147051Medicare PIN
AZP00971382OtherRXR MEDICARE
OH4295271Medicare PIN