Provider Demographics
NPI:1245223304
Name:JONES, DAVID W (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
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 1:1050 EAGLES LANDING PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9200
Mailing Address - Country:US
Mailing Address - Phone:678-289-1988
Mailing Address - Fax:678-289-1512
Practice Address - Street 1:1050 EAGLES LANDING PKWY STE 202
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9200
Practice Address - Country:US
Practice Address - Phone:678-289-1988
Practice Address - Fax:678-289-1512
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0214082080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000219128KMedicaid
GA000219128KMedicaid
06BDGLQMedicare ID - Type Unspecified