Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
DR. JON R JOLLES
Active
Individual
DR. JON R JOLLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45558
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0194069
—
MA
01
—
1200529
UNITED
—
01
—
20603
HPHC
MA
01
—
3552812
CIGNA
—
01
—
721287
TUFTS
—
01
—
JOJ08024
BCBS
MA
Enumeration date
11/03/2005
Last updated
10/03/2024
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