Provider Demographics
NPI:1639942659
Name:JONES, JAIRON BLAINE
Entity Type:Individual
Prefix:
First Name:JAIRON
Middle Name:BLAINE
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 1:2131 CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47805-2516
Mailing Address - Country:US
Mailing Address - Phone:812-243-0497
Mailing Address - Fax:
Practice Address - Street 1:2131 CLAY AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47805-2516
Practice Address - Country:US
Practice Address - Phone:812-243-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health