Provider Demographics
NPI:1821075193
Name:JONES, RODNEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
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:PO BOX 1039
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1039
Mailing Address - Country:US
Mailing Address - Phone:316-685-6112
Mailing Address - Fax:316-652-0340
Practice Address - Street 1:825 N HILLSIDE ST
Practice Address - Street 2:STE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4913
Practice Address - Country:US
Practice Address - Phone:316-733-9393
Practice Address - Fax:316-733-6116
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20454207LP2900X, 207L00000X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100174310BMedicaid
KS104412OtherBCBS
KS104412OtherBCBS