Provider Demographics
NPI:1093793523
Name:JONES, ANDREW R (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2051 HAMILL RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-6606
Mailing Address - Country:US
Mailing Address - Phone:423-877-4549
Mailing Address - Fax:423-875-8510
Practice Address - Street 1:2051 HAMILL RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-6606
Practice Address - Country:US
Practice Address - Phone:423-877-4549
Practice Address - Fax:423-875-8510
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN20771207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD20771OtherSTATE MEDICAL LICENSE
TNE81379Medicare UPIN
TN3055499Medicare ID - Type Unspecified