Randall Lee Jones, D.O.
Individual provider Active NPI Family Medicine Physician · Usafa, CO
NPI 1194716787 · NPPES record last updated Sep 29, 2008
Key facts
- NPI
- 1194716787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OP00000941 (WA)
- Practice address
- 10 MDG/Amds/SGPF
Usafa, CO 80840 - Phone
- (719) 333-5183
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP00000941 | WA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OP00000941 | WA | Yes |
Addresses
Primary practice location
10 MDG/Amds/SGPF
Usafa, CO 80840
Mailing address
1353 Montcombe Dr
Monument, CO 80132-2881
Phone (719) 488-4389
Other providers in Usafa, CO
All providers in Usafa, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.