Provider Demographics
NPI:1235190562
Name:JONES, THOMAS GORDON (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GORDON
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1511
Mailing Address - Country:US
Mailing Address - Phone:860-674-8300
Mailing Address - Fax:860-674-1055
Practice Address - Street 1:1027 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1511
Practice Address - Country:US
Practice Address - Phone:860-674-8300
Practice Address - Fax:860-674-1055
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT24367207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00-1243674Medicaid
CTC59715Medicare UPIN
CT00-1243674Medicaid