Provider Demographics
NPI:1578847661
Name:JONES, CHARLES H III
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:H
Last Name:JONES
Suffix:III
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 1:9304 NE STARDUST LN
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-1130
Mailing Address - Country:US
Mailing Address - Phone:405-778-4025
Mailing Address - Fax:
Practice Address - Street 1:9304 NE STARDUST LN
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-1130
Practice Address - Country:US
Practice Address - Phone:405-778-4025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor