Provider Demographics
NPI:1568405637
Name:JONES, W SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:W
Middle Name:SCOTT
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3950 KRESGE WAY
Mailing Address - Street 2:STE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-897-0269
Mailing Address - Fax:502-897-0214
Practice Address - Street 1:3950 KRESGE WAY
Practice Address - Street 2:STE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-897-0269
Practice Address - Fax:502-897-0214
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY19654208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00097210OtherRR MEDICARE
KY64196546Medicaid
KYBC000000311727OtherANTHEM
KY64196546Medicaid
KYP00097210OtherRR MEDICARE