Provider Demographics
NPI:1730129206
Name:JONES, EZEKIEL N II (DO)
Entity Type:Individual
Prefix:DR
First Name:EZEKIEL
Middle Name:N
Last Name:JONES
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4461 STARKEY ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-345-4946
Mailing Address - Fax:540-982-7164
Practice Address - Street 1:4461 STARKEY ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-345-4946
Practice Address - Fax:540-982-7164
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102201480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1730129206Medicaid
VA313126OtherSOUTHERN HEALTH
VAP00187257OtherRAILROAD MEDICARE
VA173460OtherANTHEM
VA7066157OtherAETNA
VA6817408OtherCIGNA
F35683Medicare UPIN
VA1730129206Medicaid