Provider Demographics
NPI:1558341610
Name:JONES, JEFF ALLEN (RPH, MS)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:ALLEN
Last Name:JONES
Suffix:
Gender:M
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 SHADOW OAK LN
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-6227
Mailing Address - Country:US
Mailing Address - Phone:801-718-1076
Mailing Address - Fax:
Practice Address - Street 1:3793 S STATE ST
Practice Address - Street 2:DIABETES SPECIALTY CENTER
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4828
Practice Address - Country:US
Practice Address - Phone:801-268-9699
Practice Address - Fax:801-268-9929
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT147224-1719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist