Provider Demographics
NPI:1578823696
Name:FLETCHER-JONES, CRYSTAL MARIE (DO)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MARIE
Last Name:FLETCHER-JONES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:41472-7146
Mailing Address - Country:US
Mailing Address - Phone:606-743-3065
Mailing Address - Fax:606-743-3066
Practice Address - Street 1:1084 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:41472-7146
Practice Address - Country:US
Practice Address - Phone:606-743-3065
Practice Address - Fax:606-743-3066
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2928207Q00000X
KY03793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine