Provider Demographics
NPI:1275250516
Name:JONES, MARCUS T
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:T
Last Name:JONES
Suffix:
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:PO BOX 612
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-0612
Mailing Address - Country:US
Mailing Address - Phone:512-676-7748
Mailing Address - Fax:
Practice Address - Street 1:1005 BAKERS CV
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5351
Practice Address - Country:US
Practice Address - Phone:512-676-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist