Provider Demographics
NPI:1407838840
Name:JONES, JAMES OLIVER JR (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:OLIVER
Last Name:JONES
Suffix:JR
Gender:M
Credentials:CRNA
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 1375
Mailing Address - Street 2:JO JONES CRNA LLC
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202
Mailing Address - Country:US
Mailing Address - Phone:505-623-7404
Mailing Address - Fax:505-623-7231
Practice Address - Street 1:113 EAST 19TH
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201
Practice Address - Country:US
Practice Address - Phone:505-627-7000
Practice Address - Fax:505-627-7007
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR35471367500000X
TX244696367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NME8954Medicaid
NME8954Medicaid