Provider Demographics
NPI:1548473713
Name:JONES-QUAIDOO, SEAN M (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:JONES-QUAIDOO
Suffix:
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 1:8440 WALNUT HILL LN STE 230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3833
Mailing Address - Country:US
Mailing Address - Phone:214-452-7705
Mailing Address - Fax:214-377-8831
Practice Address - Street 1:8440 WALNUT HILL LN STE 230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3816
Practice Address - Country:US
Practice Address - Phone:214-452-7705
Practice Address - Fax:214-377-8831
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44065207XS0117X
VA0116017695390200000X
TXP3361207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK030630OtherMEDICARE PTAN -- NORTON LEATHERMAN SPINE
KY50034085OtherPASSPORT HEALTH- NORTON LEATHERMAN SPINE
KY000000720951OtherANTHEM- NORTON LEATHERMAN SPINE
KY000057120TOtherHUMANA- NORTON LEATHERMAN SPINE
IN201030130OtherMEDICAID-- NLSC
TX352428ZGRCOtherMEDICARE GROUP, MEMBER PROVIDER NUMBER
KY7100166460OtherMEDICAID- NORTON LEATHERMAN SPINE CENTER
KY126874OtherSIHO- NORTON LEATHERMAN SPINE
KY9447007OtherCIGNA -- NLSC
TX7115360001Medicare NSC
TX352428ZGRCOtherMEDICARE GROUP, MEMBER PROVIDER NUMBER