Provider Demographics
NPI:1215962931
Name:JONES, JO ANN (MD)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 STANIFORD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2517
Mailing Address - Country:US
Mailing Address - Phone:617-724-3348
Mailing Address - Fax:617-724-8067
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-724-3348
Practice Address - Fax:617-724-8067
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E05233OtherBLUE CROSS BLUE SHIELD
B97531Medicare UPIN
E05233OtherBLUE CROSS BLUE SHIELD