Provider Demographics
NPI:1467514539
Name:JONES, LINDY MICAHEL (MD)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:MICAHEL
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7808
Mailing Address - Country:US
Mailing Address - Phone:907-586-2434
Mailing Address - Fax:907-586-2446
Practice Address - Street 1:3220 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-586-2434
Practice Address - Fax:907-586-2446
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA2958207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2985Medicaid
00WCHGTIMedicare ID - Type Unspecified
AKMD2985Medicaid