Provider Demographics
NPI:1417073537
Name:TOM JONES AND ASSOCIATES
Entity Type:Organization
Organization Name:TOM JONES AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MACKIE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-873-4263
Mailing Address - Street 1:615 JONES LN
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-8920
Mailing Address - Country:US
Mailing Address - Phone:859-873-4263
Mailing Address - Fax:
Practice Address - Street 1:615 JONES LN
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-8920
Practice Address - Country:US
Practice Address - Phone:859-873-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33001207Medicaid