Benjamin Dwayne Jones, PA-C
Individual provider Active NPI Physician Assistant · Whiteman Afb, MO
NPI 1912136342 · NPPES record last updated Dec 15, 2021
Key facts
- NPI
- 1912136342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1134 (AK)
- Practice address
- 331 Sijen Ave
Whiteman Afb, MO 65305-1269 - Phone
- (660) 687-2252
- NPI assigned
- Jul 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1134 | AK | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1134 | AK | Yes |
Addresses
Primary practice location
331 Sijen Ave
Whiteman Afb, MO 65305-1269
Mailing address
677 PSC 103
Apo, AE 09603-0007
Phone 0390434301775
Other providers in Whiteman Afb, MO
- Sallie Nonette Henderson
- Luis Hernandez
- Michael Hubbell
- Haley Elizabeth James
- Crystal Michelle Jarvis
- Linda May Jones
- Tammy Colleen Karamarinov
- Mallory Peyton Kent
- Dylan John Kielcheski
- Lauren Elise Koehn
All providers in Whiteman Afb, MO · Physician Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. 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.