Provider Demographics
NPI:1780434282
Name:PAUL A JONES MD LLC
Entity type:Organization
Organization Name:PAUL A JONES MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-203-1194
Mailing Address - Street 1:1921 RIDGE RD UNIT 1352
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-4662
Mailing Address - Country:US
Mailing Address - Phone:219-203-1156
Mailing Address - Fax:219-203-1185
Practice Address - Street 1:9339 CALUMET AVE STE A
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2879
Practice Address - Country:US
Practice Address - Phone:219-203-1156
Practice Address - Fax:219-203-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty