Provider Demographics
NPI:1902546773
Name:JONES, KEVIN E JR
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:E
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 BRADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-2005
Mailing Address - Country:US
Mailing Address - Phone:240-273-6425
Mailing Address - Fax:
Practice Address - Street 1:4901 BRADDOCK RD
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-2005
Practice Address - Country:US
Practice Address - Phone:240-273-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist