Provider Demographics
NPI:1821017559
Name:JONES, EDWARD ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:ALLEN
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 1:205 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3649
Mailing Address - Country:US
Mailing Address - Phone:501-223-2345
Mailing Address - Fax:501-296-9449
Practice Address - Street 1:205 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3649
Practice Address - Country:US
Practice Address - Phone:501-223-2345
Practice Address - Fax:501-296-9449
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR91040Medicare UPIN
AR5W991Medicare ID - Type Unspecified