Basic Information
| Provider Information | |||||||||
| NPI: | 1720188626 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JONES MEDICAL PLLC | ||||||||
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| OtherOrganizationName: | SYRACUSE PEDIATRICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 W FAYETTE ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132042859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154721488 | ||||||||
| FaxNumber: | 3154728060 | ||||||||
| Practice Location | |||||||||
| Address1: | 3175 E GENESEE ST | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132241613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152512612 | ||||||||
| FaxNumber: | 3152512616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 02/10/2009 | ||||||||
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| AuthorizedOfficialLastName: | JONES | ||||||||
| AuthorizedOfficialFirstName: | MONICA | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/ OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3152512612 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.