Dr Jon R Jolles, MD | |
51 Mill St, Building E - 17, Hanover, MA 02339-1641 | |
(781) 826-2131 | |
(781) 826-4513 |
Full Name | Dr Jon R Jolles |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 51 Mill St, Hanover, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235120601 | NPI | - | NPPES |
721287 | Other | TUFTS | |
JOJ08024 | Other | MA | BCBS |
0194069 | Medicaid | MA | |
3552812 | Other | CIGNA | |
1200529 | Other | UNITED | |
20603 | Other | MA | HPHC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 45558 (Massachusetts) | Primary |
Entity Name | Healthcare South Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396726006 PECOS PAC ID: 0941273262 Enrollment ID: O20040816000712 |
Mailing Address | Practice Location Address |
---|---|
Dr Jon R Jolles, MD Po Box 68, S Weymouth, MA 02190-0001 Ph: (781) 803-2786 | Dr Jon R Jolles, MD 51 Mill St, Building E - 17, Hanover, MA 02339-1641 Ph: (781) 826-2131 |
Mr. Thomas C Johnston, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 51 Mill St, Building E - 17, Hanover, MA 02339 Phone: 781-826-2131 Fax: 781-826-4513 | |
Kelli A Kennedy, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 51 Mill St, Bld E, Suite 17, Hcs-hanover Pediatrics, Hanover, MA 02339 Phone: 781-826-2131 |