Provider Demographics
NPI:1619918703
Name:JONES, SCOTT J (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-525-0005
Mailing Address - Fax:859-525-8806
Practice Address - Street 1:8726 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9625
Practice Address - Country:US
Practice Address - Phone:859-384-2660
Practice Address - Fax:859-384-5248
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2420142Medicaid
KYP00036424OtherRAILROAD MEDICARE
KYP00839910OtherRAILROAD MEDICARE
KY64063332Medicaid
OH2420142Medicaid
KYH81316Medicare UPIN
KYP00036424OtherRAILROAD MEDICARE
KYP00839910OtherRAILROAD MEDICARE