Provider Demographics
NPI:1548282619
Name:JONES, CHARLES M III (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:JONES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 BREMO RD
Mailing Address - Street 2:MOB SOUTH, SUITE G-7
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-288-8900
Mailing Address - Fax:804-282-9460
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:MOB SOUTH, SUITE G-7
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-288-8900
Practice Address - Fax:804-282-9460
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101043717207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA157695OtherANTHEM BCBS OF VA
VA3701668OtherAETNA HMO
VA10122015OtherMAMSI
VA615085OtherMAMSI
VA10122015Medicaid
VA764911OtherCIGNA
VA3701668OtherAETNA LIFE
VAP00229902OtherRAILROAD MEDICARE
VA248504OtherSOUTHERN HEALTH
VA10122015OtherMAMSI
VA10122015Medicaid