Provider Demographics
NPI:1366509796
Name:JONES, RICHARD A (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5350
Mailing Address - Country:US
Mailing Address - Phone:317-573-4370
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:9002 N MERIDIAN ST
Practice Address - Street 2:SUITE 222
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5350
Practice Address - Country:US
Practice Address - Phone:317-573-4370
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020463A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100047410Medicaid
IN040014763OtherMEDICARE RAILROAD
IN040014763OtherMEDICARE RAILROAD
IN100047410Medicaid