Provider Demographics
NPI:1477972289
Name:JONES, PRINCIZ
Entity Type:Individual
Prefix:
First Name:PRINCIZ
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 N YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110-2044
Mailing Address - Country:US
Mailing Address - Phone:918-574-5040
Mailing Address - Fax:
Practice Address - Street 1:2445 N YORKTOWN AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-2044
Practice Address - Country:US
Practice Address - Phone:918-574-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor