Provider Demographics
NPI:1740387471
Name:JONES, JOHN D (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13455 CAPETOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9276
Mailing Address - Country:US
Mailing Address - Phone:614-755-4815
Mailing Address - Fax:
Practice Address - Street 1:13299 SUMMERFIELD WAY
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9251
Practice Address - Country:US
Practice Address - Phone:614-866-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311473580-00OtherBWC GROUP#
OH4400103OtherUHC GROUP#
OH0153819Medicaid
OH311473580-001OtherMEDICAL MUTUAL GROUP#
OH0229050Medicaid
OHJO0785153Medicare ID - Type UnspecifiedMEDICARE PROVIDER#
OH0153819Medicaid
OH311473580-001OtherMEDICAL MUTUAL GROUP#