Provider Demographics
NPI:1619368925
Name:JONES, BRAD
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:JONES
Suffix:
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 1:898 WOODBERRY FOREST ROAD
Mailing Address - Street 2:
Mailing Address - City:WOODBERRY FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:22989
Mailing Address - Country:US
Mailing Address - Phone:540-406-7322
Mailing Address - Fax:
Practice Address - Street 1:898 WOODBERRY FOREST RD
Practice Address - Street 2:
Practice Address - City:WOODBERRY FOREST
Practice Address - State:VA
Practice Address - Zip Code:22989-8002
Practice Address - Country:US
Practice Address - Phone:540-406-7322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program