Provider Demographics
NPI:1134701196
Name:JONES, DEGORY BYRON JR
Entity Type:Individual
Prefix:MR
First Name:DEGORY
Middle Name:BYRON
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 LOWNDES DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-7254
Mailing Address - Country:US
Mailing Address - Phone:229-474-2505
Mailing Address - Fax:
Practice Address - Street 1:2706 LOWNDES DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-7254
Practice Address - Country:US
Practice Address - Phone:229-474-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor