Provider Demographics
NPI:1023727294
Name:JONES, RICHARD IRVIN III
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:IRVIN
Last Name:JONES
Suffix:III
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:IRVIN
Other - Last Name:JONES
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1722 49TH ST
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08110-2934
Mailing Address - Country:US
Mailing Address - Phone:856-495-3202
Mailing Address - Fax:856-486-5470
Practice Address - Street 1:923 HADDONFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2752
Practice Address - Country:US
Practice Address - Phone:856-495-3202
Practice Address - Fax:856-486-5470
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0343100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health