Provider Demographics
NPI:1720043078
Name:JONES, CAMERON B, (MD)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:B,
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E 4TH ST
Mailing Address - Street 2:# 200
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-1170
Mailing Address - Country:US
Mailing Address - Phone:816-753-5736
Mailing Address - Fax:816-753-5738
Practice Address - Street 1:450 E 4TH ST
Practice Address - Street 2:# 200
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1170
Practice Address - Country:US
Practice Address - Phone:816-753-5736
Practice Address - Fax:816-753-5738
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9172207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201880309Medicaid
16867026OtherBLUE CROSS BLUE SHIELD
3208006OtherUNITED HEALTHCARE
C50555Medicare UPIN
16867026OtherBLUE CROSS BLUE SHIELD
I056189AMedicare PIN