Provider Demographics
NPI:1790886240
Name:JONES, ROBERT CAMPBELL (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CAMPBELL
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 1:5310 HOMESTEAD RD NE
Mailing Address - Street 2:BLDG 400
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1437
Mailing Address - Country:US
Mailing Address - Phone:505-256-3648
Mailing Address - Fax:505-256-9778
Practice Address - Street 1:5310 HOMESTEAD RD NE
Practice Address - Street 2:BLDG 400
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1437
Practice Address - Country:US
Practice Address - Phone:505-256-3648
Practice Address - Fax:505-256-9778
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18169Medicare UPIN