Organization
DRS NEDELKOFF, PAST AND JONES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER D JONES MD (LABORATORY MEDICAL DIRECTOR)
(812) 948-7408
Entity
Organization
Contact information
Practice address
1850 STATE ST, PATHOLOGY DEPT, NEW ALBANY, IN 47150-4990
(812) 948-7408
(812) 949-5810
Mailing address
PO BOX 1286, NEW ALBANY, IN 47151-1286
(502) 458-8653
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100116000A
—
IN
01
—
1056637
PASSPORT MEDICAID
KY
01
—
1100194
UNITED HEALTHCARE
—
01
—
129043700
WORKERS COMP FLORIDA
FL
01
—
1300781
UNITED MINE WORKERS
—
01
—
280028
BLACK LUNG PROGRAM
—
05
—
7100239320
—
KY
01
—
CB2272
RAILROAD MEDICARE
—
Enumeration date
07/01/2006
Last updated
10/16/2013
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