Provider Demographics
NPI:1629836804
Name:JONES, LUGENE III
Entity Type:Individual
Prefix:
First Name:LUGENE
Middle Name:
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 1:2722 ERIE AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2154
Mailing Address - Country:US
Mailing Address - Phone:440-978-9801
Mailing Address - Fax:
Practice Address - Street 1:2722 ERIE AVE STE 219
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2154
Practice Address - Country:US
Practice Address - Phone:440-978-9801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver