Individual
THOMAS I JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 N 26TH ST, LAFAYETTE, IN 47904-2842
(765) 448-8000
(765) 448-7599
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01030374A
IN
207RH0000X
Hematology (Internal Medicine) Physician
Primary
01030374A
IN
207RX0202X
Medical Oncology Physician
01030374A
IN
207RX0202X
Medical Oncology Physician
MD205532
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000196837
ANTHEM PROVIDER NUMBER
IN
01
—
000000491794
ANTHEM PIN # / OIGL
IN
05
—
100387490
—
IN
01
—
10825335
CAQH NUMBER
IN
01
—
9397186
PHCS PID NUMBER
IN
Enumeration date
03/16/2006
Last updated
03/21/2024
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