Organization
LARRY JONES MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM BLACK (BILLING MANAGER)
(814) 224-4439
Entity
Organization
Contact information
Practice address
99 NASON DRIVE, ROARING SPRING, PA 16673
(814) 224-4439
(814) 224-5930
Mailing address
PO BOX 75, ROARING SPRING, PA 16673
(814) 224-4439
(814) 224-5930
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
502685
BLUE SHIELD
PA
Enumeration date
10/04/2006
Last updated
04/24/2014
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