| Green & Jones Oral And Maxillofacial Surgery Pllc | |
|
3935 Dupont Circle Ste. D Louisville KY 40207 | |
| (502) 897-0424 | |
| (502) 897-0427 |
| Full Name | Green & Jones Oral And Maxillofacial Surgery Pllc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 3935 Dupont Circle, Louisville, Kentucky |
| Authorized Official Name and Position | Lewis C Jones (ORAL SURGEON/OWNER) |
| Authorized Official Contact | 5028970424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green & Jones Oral And Maxillofacial Surgery Pllc 3935 Dupont Circle Ste. D Louisville KY 40207 Ph: (502) 897-0424 | Green & Jones Oral And Maxillofacial Surgery Pllc 3935 Dupont Circle Ste. D Louisville KY 40207 Ph: (502) 897-0424 |
| NPI Number | 1205300290 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 12/05/2023 |
| Medicare PECOS PAC ID | 8820324759 |
|---|---|
| Medicare Enrollment ID | O20190730001953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205300290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Ralph M Green |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619087954 PECOS PAC ID: 7214110246 Enrollment ID: I20110329000073 |
| Provider Name | Lewis C Jones |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1730382722 PECOS PAC ID: 1850537614 Enrollment ID: I20150717001064 |
| Provider Name | Gregory Way |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154731156 PECOS PAC ID: 8325342819 Enrollment ID: I20201110002649 |
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