Provider Demographics
NPI:1285964791
Name:JONES, TIMOTHY RAY
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:RAY
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4442
Mailing Address - Country:US
Mailing Address - Phone:270-442-7250
Mailing Address - Fax:
Practice Address - Street 1:116 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4442
Practice Address - Country:US
Practice Address - Phone:270-442-7250
Practice Address - Fax:270-442-7253
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies