Provider Demographics
NPI:1457341802
Name:JONES, JEFFRY L (MD)
Entity Type:Individual
Prefix:
First Name:JEFFRY
Middle Name:L
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 1:5100 W TILGHMAN ST STE 315
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9166
Mailing Address - Country:US
Mailing Address - Phone:610-395-4044
Mailing Address - Fax:610-395-5693
Practice Address - Street 1:730 EDEN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4725
Practice Address - Country:US
Practice Address - Phone:717-509-6510
Practice Address - Fax:717-569-1890
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044415L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001298342Medicaid
F39449Medicare UPIN
PA130467Medicare PIN