Basic Information
| Provider Information | |||||||||
| NPI: | 1487675120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2015 JACKSON STREET | ||||||||
| Address2: | RADIOLOGY DEPT | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460164339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656492511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2015 JACKSON STREET | ||||||||
| Address2: | RADIOLOGY DEPT | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460164339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656492511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 02/11/2008 | ||||||||
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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 | 2085R0202X | 5069601 | IN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.