Provider Demographics
NPI:1265643571
Name:JONES, CHARLA S (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLA
Middle Name:S
Last Name:JONES
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9380 MONTGOMERY RD STE 206
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7756
Mailing Address - Country:US
Mailing Address - Phone:513-216-2725
Mailing Address - Fax:513-296-7470
Practice Address - Street 1:9380 MONTGOMERY RD STE 206
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-7756
Practice Address - Country:US
Practice Address - Phone:513-216-2725
Practice Address - Fax:513-296-7470
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-014442084P0800X
KY435612084P0800X
OH350949182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100124260Medicaid
KYP400021285Medicare PIN