Individual
MARK R. JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 CHURCHMAN AVE, SUITE 100, LOUISVILLE, KY 40215-1143
(502) 363-3100
(502) 363-1110
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
30394
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000039660
ANTHEM BCBS PROV. #
KY
01
—
000001043251
ANTHEM BCBS
KY
01
—
1052404
PASSPORT HEALTH GRP #
KY
01
—
1052405
PASSPORT HEALTH PROV. #
KY
01
—
1178107
GATEWAY HEALTH
KY
05
—
200833760
—
IN
01
—
2092988
AETNA
KY
01
—
4541164
CIGNA - LKO
KY
01
—
4675796
AETNA OTHER #
KY
01
—
50115896
UNIVERSITY HEALTHCARE
FL
01
—
598967
STERLING HEALTH
KY
05
—
64303944
—
KY
01
—
92004007
RAILROAD MEDICARE
KY
01
—
P01778546
RR MEDICARE
KY
Enumeration date
09/16/2005
Last updated
03/08/2017
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