Basic Information
| Provider Information | |||||||||
| NPI: | 1952663403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | CAROL | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GILES | ||||||||
| OtherFirstName: | ELLEN | ||||||||
| OtherMiddleName: | CAROL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 36000 DARNALL LOOP | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | FORT HOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765445095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542888303 | ||||||||
| FaxNumber: | 2542888999 | ||||||||
| Practice Location | |||||||||
| Address1: | BAYNE-JONES ARMY COMMUNITY HOSPITAL | ||||||||
| Address2: | 1585 THIRD STREET | ||||||||
| City: | FORT POLK | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375313308 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2012 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | P7934 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.