Provider Demographics
NPI:1932167798
Name:JONES, WALTER WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:WILLIAM
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 1:90 N 4TH ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1648
Mailing Address - Country:US
Mailing Address - Phone:740-633-2456
Mailing Address - Fax:740-633-2334
Practice Address - Street 1:90 N 4TH ST
Practice Address - Street 2:SUITE 22
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1648
Practice Address - Country:US
Practice Address - Phone:740-633-2456
Practice Address - Fax:740-633-2334
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046773174400000X
WV10615174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH39610OtherADVANTRA/CARELINK
OH61094146600OtherOH BUREAU OF WORKERS COMP
OH0004096334OtherAETNA
OH46773OtherHEALTH PLAN OF UPPER OV
OH001723394OtherBLUE CROSS/BLUE SHIELD
WV610941466OtherWV WORKERS COMP
OH610941466OtherTRICARE
OH0468515Medicaid
OH39610OtherHEALTH ASSUR/HEALTH AMERI
000000154078OtherANTHEM BLUE CROSS
WV0095862000Medicaid
OH170000006OtherRR MEDICARE
OH0004096334OtherAETNA