Provider Demographics
NPI:1821071473
Name:JONES, EDWARD R (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10 E MORELAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3541
Mailing Address - Country:US
Mailing Address - Phone:267-385-5538
Mailing Address - Fax:267-437-3176
Practice Address - Street 1:10 E MORELAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3541
Practice Address - Country:US
Practice Address - Phone:267-385-5538
Practice Address - Fax:267-437-3176
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD017216E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0074368805OtherAMERICHOICE
PA0054039000OtherKEYSTONE HEALTH PLAN EAST
PA50039OtherAETNA
PA12945MD017216EOtherHEALTH PARTNERS
PACA1374OtherRAILROAD MEDICARE
PA0007436880003Medicaid
PA1017003OtherKEYSTONE MERCY
PA0054039000OtherPERSONAL CHOICE
PA072490OtherHIGHMARK BLUE SHIELD
PACA1374OtherRAILROAD MEDICARE
PA1017003OtherKEYSTONE MERCY