Provider Demographics
NPI:1891794111
Name:JONES, RICHARD E (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
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 1:195 STOCK ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2266
Mailing Address - Country:US
Mailing Address - Phone:717-632-1448
Mailing Address - Fax:717-632-8432
Practice Address - Street 1:195 STOCK ST
Practice Address - Street 2:SUITE 206
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2266
Practice Address - Country:US
Practice Address - Phone:717-632-1448
Practice Address - Fax:717-632-8432
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015985E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
073997Medicare ID - Type Unspecified
D71124Medicare UPIN