Provider Demographics
NPI:1952435349
Name:JONES, CLIFFORD WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:WILLIAM
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 1:301 SPRING GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2516
Mailing Address - Country:US
Mailing Address - Phone:609-561-1700
Mailing Address - Fax:
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB049802002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF48987Medicare UPIN
483502QRWMedicare ID - Type Unspecified