Provider Demographics
NPI:1407838246
Name:JONES, JOEL M (DO)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:209 VILLAGE AVE STE P
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-5639
Practice Address - Country:US
Practice Address - Phone:757-316-5050
Practice Address - Fax:757-369-2999
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMA107197207Q00000X
VA0102203384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM29030OtherPRESBYTERIAN HEATLH PLAN
NMNM014085OtherBLUE CROSS BLUE SHEILD
NMQ0019Medicaid
NMNM300396Medicare PIN
NMNM014085OtherBLUE CROSS BLUE SHEILD