Provider Demographics
NPI:1215188453
Name:JONES, MICHAEL BRANDON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BRANDON
Last Name:JONES
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:600 GRESHAM DR STE 8600
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-6005
Mailing Address - Fax:
Practice Address - Street 1:850 KEMPSVILLE RD
Practice Address - Street 2:STE 100G
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5977
Practice Address - Fax:757-275-9913
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2017-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002820363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant