Provider Demographics
NPI:1447912597
Name:JONES, RICHARD (CHW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 W BOIS D ARC AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-4824
Mailing Address - Country:US
Mailing Address - Phone:580-252-0227
Mailing Address - Fax:
Practice Address - Street 1:1401 W BOIS D ARC AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4824
Practice Address - Country:US
Practice Address - Phone:580-252-0227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker