Basic Information
| Provider Information | |||||||||
| NPI: | 1740223601 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
| Address2: | MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135889000 | ||||||||
| FaxNumber: | 9135889822 | ||||||||
| Practice Location | |||||||||
| Address1: | 7405 RENNER RD | ||||||||
| Address2: | KU MEDWEST | ||||||||
| City: | SHAWNEE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662179414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135888400 | ||||||||
| FaxNumber: | 9135888413 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 11/20/2009 | ||||||||
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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 | 207R00000X | 04-20727 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | R8N55 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110217631 | 01 | RR MEDICARE | OTHER | 100348580B | 05 | KS | MEDICAID | 2443158 | 01 | AETNA | OTHER | 355131 | 01 | FIRSTGUARD | OTHER | 481159444 | 01 | JAYHAWK TAX ID | OTHER | 17429017 | 01 | BCBS | OTHER | 10001313700 | 01 | CHP PROVIDER NUMBER | OTHER |