Provider Demographics
NPI:1003496779
Name:JONES, LORI ANGELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANGELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-749-2645
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:4353 HWY 1 S
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-5826
Practice Address - Country:US
Practice Address - Phone:225-749-2645
Practice Address - Fax:225-749-8216
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA341262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program