Provider Demographics
NPI:1518093046
Name:JONES, LISA C (DO)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:610-387-4520
Mailing Address - Fax:610-387-4526
Practice Address - Street 1:100 MARIS GROVE WAY
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1282
Practice Address - Country:US
Practice Address - Phone:610-387-4520
Practice Address - Fax:610-387-4526
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2024-08-12
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Provider Licenses
StateLicense IDTaxonomies
PAOS014786207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2359401OtherMLHC TIN
PA158683HK1Medicare PIN
PA440771OtherMLHC MEDICARE AA #