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Individual

DR. EDWARD LESLIE JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 SUSQUEHANNOCK TRL, ATHENS, PA 18810-9701
(570) 423-0008
Mailing address
55 SUSQUEHANNOCK TRL, ATHENS, PA 18810-9701
(570) 423-0008

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
115759-1
NY
207Q00000X
Family Medicine Physician
Primary
MD011609E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009248160001
PA
05
00793980
NY
01
080159964
RR MEDICARE PIN
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039830
MEDICARE GROUP
PA
Enumeration date
03/15/2006
Last updated
02/27/2025
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