Provider Demographics
NPI:1881120038
Name:JONES, CORY DEON (MD)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:DEON
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HOSPITAL PL
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-6999
Mailing Address - Country:US
Mailing Address - Phone:907-714-4529
Mailing Address - Fax:907-714-4696
Practice Address - Street 1:250 HOSPITAL PL
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-6999
Practice Address - Country:US
Practice Address - Phone:907-714-4529
Practice Address - Fax:907-714-4596
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK206087207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK206087OtherALASKA LICENSE