Provider Demographics
NPI:1770337099
Name:JONES, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
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 1:1113 HIGHLAND AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26187-2102
Mailing Address - Country:US
Mailing Address - Phone:734-756-1475
Mailing Address - Fax:
Practice Address - Street 1:1113 HIGHLAND AVE APT 4
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187-2102
Practice Address - Country:US
Practice Address - Phone:734-756-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant