Individual
DR. KEVIN L JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 N SAMUEL MOORE PKWY, STE A, MOORESVILLE, IN 46158-1467
(317) 483-5080
(317) 483-5085
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01046699A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200139740
—
IN
Enumeration date
06/28/2006
Last updated
01/13/2021
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