Provider Demographics
NPI:1437101003
Name:JONES, KEITH A (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
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 156
Mailing Address - Street 2:
Mailing Address - City:ROCKFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42274-0156
Mailing Address - Country:US
Mailing Address - Phone:270-745-0044
Mailing Address - Fax:270-745-0042
Practice Address - Street 1:178 E 4TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-1820
Practice Address - Country:US
Practice Address - Phone:270-726-3164
Practice Address - Fax:270-726-1520
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4494111N00000X
KY250031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001592Medicaid
KY6084301Medicare ID - Type Unspecified
KY85001592Medicaid