Provider Demographics
NPI:1831397884
Name:JONES, MICHAEL DEAN (NP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DEAN
Last Name:JONES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 644836
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-4836
Mailing Address - Country:US
Mailing Address - Phone:513-557-4260
Mailing Address - Fax:513-557-3214
Practice Address - Street 1:4182 TONYA TRL
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8549
Practice Address - Country:US
Practice Address - Phone:513-737-1999
Practice Address - Fax:513-887-0123
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 272088-COA1163W00000X
OHCOA.09471-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00866562OtherRAILROAD MEDICARE
OH3090373Medicaid
OH3090373Medicaid