Provider Demographics
NPI:1093509507
Name:JONES, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JONES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 TENMILE RD
Mailing Address - Street 2:
Mailing Address - City:WALLACE
Mailing Address - State:WV
Mailing Address - Zip Code:26448-8712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1308 TENMILE RD
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:WV
Practice Address - Zip Code:26448-8712
Practice Address - Country:US
Practice Address - Phone:304-266-0975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide