Provider Demographics
NPI:1063461432
Name:JONES, DOUGLAS H (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
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 1:222 ALEXANDER ST
Mailing Address - Street 2:MONROE COURT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4039
Mailing Address - Country:US
Mailing Address - Phone:585-922-8350
Mailing Address - Fax:585-922-8355
Practice Address - Street 1:222 ALEXANDER ST
Practice Address - Street 2:MONROE COURT
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4039
Practice Address - Country:US
Practice Address - Phone:585-922-8350
Practice Address - Fax:585-922-8355
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138757207RA0201X, 207RR0500X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03010976Medicaid
NYP00026205OtherRAILROAD MEDICARE
NY03010976Medicaid
NYCC6177Medicare PIN