Provider Demographics
NPI:1558140053
Name:JONES, BARRY LAMONT
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:LAMONT
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 1:732 CHARLEMAGNE BLVD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3241
Mailing Address - Country:US
Mailing Address - Phone:269-270-2605
Mailing Address - Fax:
Practice Address - Street 1:732 CHARLEMAGNE BLVD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3241
Practice Address - Country:US
Practice Address - Phone:269-270-2605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJ520081488817343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)