Provider Demographics
NPI:1912376104
Name:JONES, RICHARD ALAN JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:JONES
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:7181 S CAMPUS VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4312
Mailing Address - Country:US
Mailing Address - Phone:801-965-3505
Mailing Address - Fax:
Practice Address - Street 1:6550 S MILLROCK DR STE 150
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84121-4053
Practice Address - Country:US
Practice Address - Phone:212-880-5494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2020-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50.006414RX363A00000X
VA0110-007165363A00000X
TN4128363A00000X
SC3545363A00000X
CT4802363A00000X
FLPA9113223363A00000X
MI5601009907363A00000X
NY024950363A00000X
UT9515458-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant