Provider Demographics
NPI:1083879563
Name:LISA P JONES MD PLLC
Entity Type:Organization
Organization Name:LISA P JONES MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:PAYNE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-787-1950
Mailing Address - Street 1:57 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4836
Mailing Address - Country:US
Mailing Address - Phone:931-787-1950
Mailing Address - Fax:931-787-1953
Practice Address - Street 1:57 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4836
Practice Address - Country:US
Practice Address - Phone:931-787-1950
Practice Address - Fax:931-787-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29645261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH23585Medicare UPIN