Provider Demographics
NPI:1831167386
Name:JONES, LISA M (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:874 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6232
Practice Address - Country:US
Practice Address - Phone:508-992-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223737207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0039517OtherNEIGHBORHOOD HEALTH PLAN
MA2104962Medicaid
MA31915-9OtherBCBSRI
MA408558OtherBLUE CHIP
MA4642908OtherAETNA
MA010683OtherTUFTS
MA000000035682OtherBMC HEALTHNET
MA2479853OtherCIGNA
MA005329OtherSENIOR WHOLE HEALTH
MA96118501OtherNETWORK HEALTH
MAAA79884OtherHARVARD PILGRIM
MA88334OtherCHILDRENS MEDICAL SECURIT
MAJ28942OtherBCBSMA
MA96118501OtherNETWORK HEALTH
MA2104962Medicaid