Basic Information
Provider Information
NPI: 1306370051
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: PATRICK
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3889
Address2:  
City: JOHNSON CITY
State: TN
PostalCode: 376023889
CountryCode: US
TelephoneNumber: 4237942457
FaxNumber: 4232839480
Practice Location
Address1: UNIVERSITY OF KENTUCKY 800 ROSE STREET
Address2:  
City: LEXINGTON
State: KY
PostalCode: 40536
CountryCode: US
TelephoneNumber: 8593232636
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/19/2017
LastUpdateDate: 03/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XR4456KYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X4357TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home