Provider Demographics
NPI:1700955721
Name:JONES ENT, INC
Entity Type:Organization
Organization Name:JONES ENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANI
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-757-5292
Mailing Address - Street 1:7891 BROADWAY STE A
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5556
Mailing Address - Country:US
Mailing Address - Phone:219-756-3988
Mailing Address - Fax:219-756-2595
Practice Address - Street 1:255 E 90TH DRIVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-756-3988
Practice Address - Fax:219-756-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028918A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN234010Medicare PIN