Provider Demographics
NPI:1578023016
Name:JONES, AUSTIN SCOTT MORRIS (CH(R)C, CPHT)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:SCOTT MORRIS
Last Name:JONES
Suffix:
Gender:M
Credentials:CH(R)C, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 PAUL BUNYAN DR NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-2435
Mailing Address - Country:US
Mailing Address - Phone:218-333-4032
Mailing Address - Fax:218-333-4035
Practice Address - Street 1:421 PAUL BUNYAN DR NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2435
Practice Address - Country:US
Practice Address - Phone:218-333-4032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHTC048291183700000X
WI183700000X
390200000X
MAPT24765183700000X
MN732609183700000X, 183700000X, 183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program