Provider Demographics
NPI:1295097913
Name:JONES, KEVIN A (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
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 1:1614 25TH ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-5000
Mailing Address - Country:US
Mailing Address - Phone:812-277-0118
Mailing Address - Fax:812-277-0127
Practice Address - Street 1:1614 25TH ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-5000
Practice Address - Country:US
Practice Address - Phone:812-277-0118
Practice Address - Fax:812-277-0127
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01077771A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics