Provider Demographics
NPI:1295998011
Name:JONES, JEFFERY M (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2603 KENTUCKY AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3830
Mailing Address - Country:US
Mailing Address - Phone:270-443-6472
Mailing Address - Fax:270-442-1649
Practice Address - Street 1:2603 KENTUCKY AVE STE 402
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3830
Practice Address - Country:US
Practice Address - Phone:270-443-6472
Practice Address - Fax:270-442-1649
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.120676207T00000X
KY05620207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036120676Medicaid
IL721089OtherAETNA
KY7100914880Medicaid
3932056OtherBCBS
3932056OtherBCBS