Provider Demographics
NPI:1740243005
Name:JONES, GRANT L (MD)
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-3600
Mailing Address - Fax:614-293-2910
Practice Address - Street 1:2835 FRED TAYLOR DR STE 2000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1552
Practice Address - Country:US
Practice Address - Phone:614-293-3600
Practice Address - Fax:614-293-2910
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066742207X00000X
OH35.066742207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2083721Medicaid
G65627Medicare UPIN
OHJO0866523Medicare PIN
OHJO0866524Medicare PIN