Provider Demographics
NPI:1467525196
Name:JONES, DEBORAH JEANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JEANNE
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-6716
Mailing Address - Country:US
Mailing Address - Phone:856-455-7935
Mailing Address - Fax:
Practice Address - Street 1:15 ROADSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:NJ
Practice Address - Zip Code:08353
Practice Address - Country:US
Practice Address - Phone:856-455-4700
Practice Address - Fax:856-455-1567
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00454900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6720404Medicaid
NJU59254Medicare UPIN
NJ6720404Medicaid