Provider Demographics
NPI:1619181062
Name:JONES, LOREN M (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LANGLEY AFB
Mailing Address - State:VA
Mailing Address - Zip Code:23665-2025
Mailing Address - Country:US
Mailing Address - Phone:757-764-9631
Mailing Address - Fax:757-764-7329
Practice Address - Street 1:45 PINE ST
Practice Address - Street 2:
Practice Address - City:LANGLEY AFB
Practice Address - State:VA
Practice Address - Zip Code:23665-2025
Practice Address - Country:US
Practice Address - Phone:757-764-9631
Practice Address - Fax:757-764-7329
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052836A207Y00000X
VA0101253017207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology