Provider Demographics
NPI:1386704799
Name:JONES, CHAD A (PHARM D)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:A
Last Name:JONES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21471 E 330 RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-4067
Mailing Address - Country:US
Mailing Address - Phone:918-789-3553
Mailing Address - Fax:
Practice Address - Street 1:406 W 6TH ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016-1640
Practice Address - Country:US
Practice Address - Phone:918-789-2241
Practice Address - Fax:918-789-3705
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist