Provider Demographics
NPI:1356366694
Name:JONES, HAROLD M (DPM)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SEVERANCE CIR STE 505
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1588
Mailing Address - Country:US
Mailing Address - Phone:216-291-5151
Mailing Address - Fax:216-291-4460
Practice Address - Street 1:5 SEVERANCE CIR STE 505
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1588
Practice Address - Country:US
Practice Address - Phone:216-291-5151
Practice Address - Fax:216-291-4460
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.002812213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0916254Medicaid
OH402190OtherWELLCARE
OH000000495421OtherANTHEM BLUE SHIELD
OHU41228Medicare UPIN
OH0736133Medicare PIN
OH402190OtherWELLCARE
OH0916254Medicaid