Provider Demographics
NPI:1639162092
Name:JONES, CHRISTOPHER ALAN (PA C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:JONES
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 TAMIAMI TRL N STE 103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-8143
Mailing Address - Country:US
Mailing Address - Phone:239-643-9977
Mailing Address - Fax:239-643-3424
Practice Address - Street 1:625 TAMIAMI TRL N STE 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-8143
Practice Address - Country:US
Practice Address - Phone:239-643-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000163363A00000X
FL9100972363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2690XMedicare ID - Type Unspecified
S82742Medicare UPIN