Provider Demographics
NPI:1609961606
Name:JONES, DAVID L (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15680 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1808
Mailing Address - Country:US
Mailing Address - Phone:402-933-3660
Mailing Address - Fax:402-933-3682
Practice Address - Street 1:15680 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1808
Practice Address - Country:US
Practice Address - Phone:402-933-3660
Practice Address - Fax:402-933-3682
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250166-00Medicaid
NE100250166-00Medicaid