Provider Demographics
NPI:1720833718
Name:JONES, HARRISON ALEXANDER
Entity Type:Individual
Prefix:
First Name:HARRISON
Middle Name:ALEXANDER
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 1:5443 RIPPLEMEAD CT
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8387
Mailing Address - Country:US
Mailing Address - Phone:614-725-8210
Mailing Address - Fax:
Practice Address - Street 1:5443 RIPPLEMEAD CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8387
Practice Address - Country:US
Practice Address - Phone:614-725-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker