Basic Information
| Provider Information | |||||||||
| NPI: | 1497720486 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | LYNDALL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JONES | ||||||||
| OtherFirstName: | LYNDY | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4450 S RURAL RD | ||||||||
| Address2: | C-216 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852827037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808203188 | ||||||||
| FaxNumber: | 4808385033 | ||||||||
| Practice Location | |||||||||
| Address1: | 4450 S RURAL RD | ||||||||
| Address2: | C-216 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852827037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808203188 | ||||||||
| FaxNumber: | 4808385033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 11/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 19096 | AZ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 5926009 | 01 | HEALTH NET | OTHER | 84334 | 01 | PACIFICARE | OTHER | 2780450 | 01 | AHCCCS | OTHER | AZ0867040 | 01 | AZ | BLUE CROSS OF AZ | OTHER | 27780450 | 01 | PHOENIX HEALTH PLAN | OTHER |