Provider Demographics
NPI:1760662373
Name:JONES, JAYNA ROBYN (MD)
Entity Type:Individual
Prefix:
First Name:JAYNA
Middle Name:ROBYN
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MADISON SQUARE DR STE C
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2792
Mailing Address - Country:US
Mailing Address - Phone:270-821-6262
Mailing Address - Fax:270-821-6272
Practice Address - Street 1:230 MADISON SQUARE DR STE C
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2792
Practice Address - Country:US
Practice Address - Phone:270-821-6262
Practice Address - Fax:270-821-6272
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42115207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY42115OtherMEDICAL LICENSE
KYR1522OtherMEDICAL LICENSE
KY1202001Medicare PIN
KYR1522OtherMEDICAL LICENSE
KYP00473528Medicare PIN
KY00503015Medicare PIN