Provider Demographics
NPI:1457394538
Name:JONES, RHYS (MD)
Entity Type:Individual
Prefix:DR
First Name:RHYS
Middle Name:
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 1:170 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2323
Mailing Address - Country:US
Mailing Address - Phone:973-865-7254
Mailing Address - Fax:
Practice Address - Street 1:2800 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1311
Practice Address - Country:US
Practice Address - Phone:805-238-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06691000207Q00000X
CAC176161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG92965Medicare UPIN
NJ027142WC0Medicare PIN