Provider Demographics
NPI:1548243983
Name:JONES, AMY L (PAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BALA PLZ STE 620
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1416
Mailing Address - Country:US
Mailing Address - Phone:610-664-3300
Mailing Address - Fax:
Practice Address - Street 1:1 BALA PLZ STE 620
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1416
Practice Address - Country:US
Practice Address - Phone:610-664-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA006684363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
085179Medicare ID - Type UnspecifiedGROUP
095218E48Medicare ID - Type UnspecifiedPART B