Provider Demographics
NPI:1053363713
Name:JONES, EDWARD MORGAN (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MORGAN
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-4011
Mailing Address - Country:US
Mailing Address - Phone:304-636-3570
Mailing Address - Fax:304-636-6646
Practice Address - Street 1:15 RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4011
Practice Address - Country:US
Practice Address - Phone:304-636-3570
Practice Address - Fax:304-636-6646
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001723007OtherBLUE CROSS/ BLUE SHIELD
WV1025179OtherWV WORKERS' COMPENSATION
WV001723007OtherBLUE CROSS/ BLUE SHIELD
WV1025179OtherWV WORKERS' COMPENSATION