Provider Demographics
NPI:1215905146
Name:JONES, JOHN HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOWARD
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 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 HIGH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3198
Practice Address - Country:US
Practice Address - Phone:570-321-2805
Practice Address - Fax:570-321-2806
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029003E2083P0011X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA823986OtherFIRST PRIORITY HEALTH (FOR THE WOUND CTR)
PA047505OtherHIGHMARK BLUE SHIELD
PA119184OtherUNITEDHEALTHCARE
PA2178496OtherAETNA
PA0010128480007Medicaid
PA0010128480008Medicaid
PA813845OtherFIRST PRIORITY HEALTH
PAB96828OtherHEALTHAMERICA
PA0010128480008Medicaid
PA0010128480007Medicaid
PA047505Medicare PIN