Provider Demographics
NPI:1952619942
Name:JONES DERMATOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:JONES DERMATOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:775-851-7546
Mailing Address - Street 1:6120 MAE ANNE AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-4726
Mailing Address - Country:US
Mailing Address - Phone:775-851-7546
Mailing Address - Fax:775-746-8987
Practice Address - Street 1:6120 MAE ANNE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-4726
Practice Address - Country:US
Practice Address - Phone:775-851-7546
Practice Address - Fax:775-746-8987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7871261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVE45823Medicare UPIN