Provider Demographics
NPI:1457775603
Name:JONES WELLNESS & CARDIOVASCULAR
Entity type:Organization
Organization Name:JONES WELLNESS & CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BOZELLY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-655-3074
Mailing Address - Street 1:3717 LAKE TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-8357
Mailing Address - Country:US
Mailing Address - Phone:504-258-1766
Mailing Address - Fax:
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3140
Practice Address - Country:US
Practice Address - Phone:504-662-3763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13825R207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1434698Medicaid
LAH23280Medicare UPIN
LA1434698Medicaid