Provider Demographics
NPI:1720781156
Name:JONES, PATRICK ARLON
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ARLON
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 1:926 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LYNDON
Mailing Address - State:KS
Mailing Address - Zip Code:66451-9509
Mailing Address - Country:US
Mailing Address - Phone:785-219-9066
Mailing Address - Fax:
Practice Address - Street 1:4100 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5082
Practice Address - Country:US
Practice Address - Phone:785-219-9906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer