Provider Demographics
NPI:1508327875
Name:JONES, LATHERN BARNARD
Entity Type:Individual
Prefix:
First Name:LATHERN
Middle Name:BARNARD
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45772 JONES WAY
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-8821
Mailing Address - Country:US
Mailing Address - Phone:904-507-8966
Mailing Address - Fax:
Practice Address - Street 1:45772 JONES WAY
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011
Practice Address - Country:US
Practice Address - Phone:904-507-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient Transport