Provider Demographics
NPI:1730470410
Name:JONES, TRAVIS WAYLAND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:WAYLAND
Last Name:JONES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1665
Mailing Address - Country:US
Mailing Address - Phone:812-949-0641
Mailing Address - Fax:812-949-1068
Practice Address - Street 1:2022 E SPRING ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1665
Practice Address - Country:US
Practice Address - Phone:812-949-0641
Practice Address - Fax:812-949-1068
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021202A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist