Provider Demographics
NPI:1366104861
Name:JONES, EDWARD O'NEAL
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:O'NEAL
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 1:5131 BUNDY RD APT B25
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-5346
Mailing Address - Country:US
Mailing Address - Phone:901-707-1921
Mailing Address - Fax:
Practice Address - Street 1:5131 BUNDY RD APT B25
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-5346
Practice Address - Country:US
Practice Address - Phone:901-707-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator