Provider Demographics
NPI:1881668705
Name:JONES, SCOT ALAN (PT)
Entity Type:Individual
Prefix:PROF
First Name:SCOT
Middle Name:ALAN
Last Name:JONES
Suffix:
Gender:M
Credentials:PT
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 52396
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-2396
Mailing Address - Country:US
Mailing Address - Phone:337-233-8080
Mailing Address - Fax:337-237-1623
Practice Address - Street 1:201 W GLORIA SWITCH RD
Practice Address - Street 2:SUITE H
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2590
Practice Address - Country:US
Practice Address - Phone:337-233-8080
Practice Address - Fax:337-237-1623
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H350CB92Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER