Provider Demographics
NPI:1336556927
Name:JONES, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-4011
Mailing Address - Country:US
Mailing Address - Phone:785-462-1310
Mailing Address - Fax:785-462-1312
Practice Address - Street 1:1605 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-4011
Practice Address - Country:US
Practice Address - Phone:785-462-1310
Practice Address - Fax:785-462-1312
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist