Provider Demographics
NPI:1992919773
Name:JONES, B. T. JR (PA)
Entity type:Individual
Prefix:
First Name:B. T.
Middle Name:
Last Name:JONES
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 BENTHAM WAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7937
Mailing Address - Country:US
Mailing Address - Phone:405-324-0418
Mailing Address - Fax:
Practice Address - Street 1:2601 SPENCER RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3649
Practice Address - Country:US
Practice Address - Phone:405-427-4789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1444363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant