Provider Demographics
NPI:1316949662
Name:JONES, DAVID R (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13 SAINT ALBANS CIRCLE
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3619
Mailing Address - Country:US
Mailing Address - Phone:484-422-8647
Mailing Address - Fax:484-422-8648
Practice Address - Street 1:13 SAINT ALBANS CIRCLE
Practice Address - Street 2:SUITE C
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3619
Practice Address - Country:US
Practice Address - Phone:610-853-2900
Practice Address - Fax:610-853-2980
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS008904L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016539140002Medicaid
P00063222OtherRAILROAD MEDICARE
000025K9LMedicare PIN