Provider Demographics
NPI:1891768800
Name:JONES, RODERICK C (DC)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:C
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12574 INDIAN ROCKS RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3007
Mailing Address - Country:US
Mailing Address - Phone:727-596-3601
Mailing Address - Fax:727-596-3602
Practice Address - Street 1:12574 INDIAN ROCKS RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3007
Practice Address - Country:US
Practice Address - Phone:727-596-3601
Practice Address - Fax:727-596-3602
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380273600Medicaid
FLU47001Medicare UPIN
FL380273600Medicaid