Provider Demographics
NPI:1447225552
Name:JONES, LOYD KEVIN (PA-C)
Entity Type:Individual
Prefix:
First Name:LOYD
Middle Name:KEVIN
Last Name:JONES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23901 MAVERICK
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:OK
Mailing Address - Zip Code:73061-9327
Mailing Address - Country:US
Mailing Address - Phone:405-762-1222
Mailing Address - Fax:
Practice Address - Street 1:1900 N 14TH ST
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2035
Practice Address - Country:US
Practice Address - Phone:580-765-3321
Practice Address - Fax:580-765-0597
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1359207P00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q18506Medicare UPIN