Provider Demographics
NPI:1962512178
Name:JONES, WILLIAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:165 N VILLAGE AVE
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3761
Mailing Address - Country:US
Mailing Address - Phone:516-766-0393
Mailing Address - Fax:516-766-2405
Practice Address - Street 1:165 N VILLAGE AVE
Practice Address - Street 2:SUITE # 5
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3761
Practice Address - Country:US
Practice Address - Phone:516-766-0393
Practice Address - Fax:516-766-2405
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2090392081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01910434Medicaid
NYG82832Medicare UPIN
NY1I9593Medicare ID - Type Unspecified