Provider Demographics
NPI:1902870033
Name:JONES, JAY T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:T
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4530 DENALI CV
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-9117
Mailing Address - Country:US
Mailing Address - Phone:812-374-9344
Mailing Address - Fax:
Practice Address - Street 1:3707 NEW VISION DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1702
Practice Address - Country:US
Practice Address - Phone:260-469-4763
Practice Address - Fax:260-484-5919
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012361702085R0202X
IN01063734A2085R0202X
OH35 1250432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology