Provider Demographics
NPI:1508071929
Name:JONES, CHARLES D III (HEARING SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:D
Last Name:JONES
Suffix:III
Gender:M
Credentials:HEARING SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 MAHONING AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2333
Mailing Address - Country:US
Mailing Address - Phone:330-270-1800
Mailing Address - Fax:
Practice Address - Street 1:5620 MAHONING AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2333
Practice Address - Country:US
Practice Address - Phone:330-270-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2194237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0135071Medicaid