Provider Demographics
NPI:1831220953
Name:ISON-JONES, LINDA LOU
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LOU
Last Name:ISON-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5551 CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8199
Mailing Address - Country:US
Mailing Address - Phone:937-466-2650
Mailing Address - Fax:
Practice Address - Street 1:9368 BALLENTINE RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-9008
Practice Address - Country:US
Practice Address - Phone:937-393-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLINDA2016277Medicaid