Basic Information
Provider Information
NPI: 1194911859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: JENNIFER
MiddleName: CLARE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 875 BLAKE WILBUR DRIVE
Address2: STANFORD CANCER CENTER, DEPT RADIATION ONCOLOGY
City: STANFORD
State: CA
PostalCode: 943055847
CountryCode: US
TelephoneNumber: 6507236171
FaxNumber:  
Practice Location
Address1: 875 BLAKE WILBUR DRIVE
Address2: STANFORD CANCER CENTER, DEPT RADIATION ONCOLOGY
City: STANFORD
State: CA
PostalCode: 943055847
CountryCode: US
TelephoneNumber: 6507236171
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/17/2007
LastUpdateDate: 09/17/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XA97284CAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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