Provider Demographics
NPI:1760159057
Name:JONES, CURTIS DARNELL
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:DARNELL
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 1:805 HANCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3346
Mailing Address - Country:US
Mailing Address - Phone:757-485-3644
Mailing Address - Fax:
Practice Address - Street 1:5917 HIGH ST W
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-4505
Practice Address - Country:US
Practice Address - Phone:757-686-5929
Practice Address - Fax:757-686-8503
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022073351835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care