Provider Demographics
NPI:1386057859
Name:JONES, ANDREW LEE (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5171 CUB LAKE RD STE B230
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-7882
Mailing Address - Country:US
Mailing Address - Phone:801-419-3011
Mailing Address - Fax:928-537-6737
Practice Address - Street 1:5171 CUB LAKE RD STE B230
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7882
Practice Address - Country:US
Practice Address - Phone:801-419-3011
Practice Address - Fax:928-537-6737
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301104926208000000X
AZ54187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics