Basic Information
Provider Information
NPI: 1811281538
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: KEA
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2257655727
FaxNumber: 2257659196
Practice Location
Address1: 7777 HENNESSY BLVD
Address2: SUITE 701
City: BATON ROUGE
State: LA
PostalCode: 708084300
CountryCode: US
TelephoneNumber: 2257655864
FaxNumber: 2257652013
Other Information
ProviderEnumerationDate: 05/31/2011
LastUpdateDate: 03/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X207213LAN Allopathic & Osteopathic PhysiciansHospitalist 
390200000X TNN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X207213LAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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