Provider Demographics
NPI:1811190176
Name:JONES, DANIEL BOOTH II (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BOOTH
Last Name:JONES
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:B
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:72562 STATE ROUTE 250
Mailing Address - Street 2:
Mailing Address - City:DILLIONVALE
Mailing Address - State:OH
Mailing Address - Zip Code:43917
Mailing Address - Country:US
Mailing Address - Phone:740-738-0020
Mailing Address - Fax:740-738-0625
Practice Address - Street 1:72562 STATE ROUTE 250
Practice Address - Street 2:
Practice Address - City:DILLIONVALE
Practice Address - State:OH
Practice Address - Zip Code:43917
Practice Address - Country:US
Practice Address - Phone:740-738-0020
Practice Address - Fax:740-738-0625
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2254207Q00000X
OH34.009232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2976212Medicaid