Provider Demographics
NPI:1912911553
Name:JONES, RAY L (DO)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-0266
Mailing Address - Country:US
Mailing Address - Phone:304-647-4968
Mailing Address - Fax:304-647-4987
Practice Address - Street 1:304 SENECA TRL
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1320
Practice Address - Country:US
Practice Address - Phone:304-647-4968
Practice Address - Fax:304-647-4987
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1295208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0125103000Medicaid
WVA67207Medicare UPIN
WV0699784Medicare PIN