Provider Demographics
NPI:1447569702
Name:ALICIA JONES, MD PC
Entity Type:Organization
Organization Name:ALICIA JONES, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-571-7777
Mailing Address - Street 1:9600 S 1300 E
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3766
Mailing Address - Country:US
Mailing Address - Phone:801-571-7777
Mailing Address - Fax:801-523-1848
Practice Address - Street 1:9600 S 1300 E
Practice Address - Street 2:SUITE 300
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3766
Practice Address - Country:US
Practice Address - Phone:801-571-7777
Practice Address - Fax:801-523-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7641755-1205261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center