Provider Demographics
NPI:1871685347
Name:JONES, PYTHIAS DAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:PYTHIAS
Middle Name:DAMON
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 1:3645 WARRENSVILLE CENTER RD
Mailing Address - Street 2:#216
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5247
Mailing Address - Country:US
Mailing Address - Phone:216-752-5020
Mailing Address - Fax:
Practice Address - Street 1:3645 WARRENSVILLE CENTER RD
Practice Address - Street 2:#216
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5247
Practice Address - Country:US
Practice Address - Phone:216-752-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH0147332084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0815845Medicaid
OH0815845Medicaid
OHJO0665261Medicare PIN