Provider Demographics
NPI:1841570488
Name:JONES, G. ERIC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:G.
Middle Name:ERIC
Last Name:JONES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5168 N BROOKSTONE ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-7639
Mailing Address - Country:US
Mailing Address - Phone:405-305-7634
Mailing Address - Fax:
Practice Address - Street 1:5505 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3825
Practice Address - Country:US
Practice Address - Phone:316-689-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-14456OtherKANSAS BOARD OF PHARMACY PERSONAL ID NUMBER