Provider Demographics
NPI:1164403382
Name:JONES, GARY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3214 CAROL CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-4703
Mailing Address - Country:US
Mailing Address - Phone:318-442-5345
Mailing Address - Fax:
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-442-0106
Practice Address - Fax:318-448-8918
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014656208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1349658Medicaid
LA1349658Medicaid
LAD87089Medicare UPIN