Basic Information
Provider Information
NPI: 1003823048
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 26666
Address2: PROVIDER ENROLLMENT
City: ALBUQUERQUE
State: NM
PostalCode: 871256666
CountryCode: US
TelephoneNumber: 5059236770
FaxNumber:  
Practice Location
Address1: 8300 CONSTITUTION AVE NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871107613
CountryCode: US
TelephoneNumber: 5052722700
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/02/2006
LastUpdateDate: 02/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X99-60NMY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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