Provider Demographics
NPI:1699793208
Name:JONES, STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 FERN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-3529
Mailing Address - Country:US
Mailing Address - Phone:502-961-9355
Mailing Address - Fax:502-961-9357
Practice Address - Street 1:3407 FERN VALLEY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-3529
Practice Address - Country:US
Practice Address - Phone:502-961-9355
Practice Address - Fax:502-961-9357
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY4599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001345Medicaid
KY6092501Medicare ID - Type Unspecified
KY85001345Medicaid