Basic Information
| Provider Information | |||||||||
| NPI: | 1134105190 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3183 N NATIONAL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472013164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123721581 | ||||||||
| FaxNumber: | 8123764028 | ||||||||
| Practice Location | |||||||||
| Address1: | 3183 N NATIONAL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 472013164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123721581 | ||||||||
| FaxNumber: | 8123764028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 02/28/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 01027601 | IN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 100051790A | 05 | IN | MEDICAID | 000000510119 | 01 | ANTHEM | OTHER |