Provider Demographics
NPI:1730383233
Name:JONES, ALYSON IRENE (MD)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:IRENE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 122165
Mailing Address - Street 2:DEPT 2165
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2165
Mailing Address - Country:US
Mailing Address - Phone:337-494-2921
Mailing Address - Fax:337-494-6523
Practice Address - Street 1:1717 OAK PARK BLVD
Practice Address - Street 2:3RD AVE
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8991
Practice Address - Country:US
Practice Address - Phone:337-494-4900
Practice Address - Fax:337-494-4936
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA301490208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1058271Medicaid