Provider Demographics
NPI:1275587883
Name:JONAS, KARL CRAWFORD JR (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:CRAWFORD
Last Name:JONAS
Suffix:JR
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:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-0279
Mailing Address - Country:US
Mailing Address - Phone:901-476-9087
Mailing Address - Fax:901-476-6901
Practice Address - Street 1:1995 HIGHWAY 51 SOUTH
Practice Address - Street 2:SUITE 204
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3655
Practice Address - Country:US
Practice Address - Phone:901-476-9087
Practice Address - Fax:901-476-6901
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016007208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0081448OtherBCBST
TN3011443Medicaid
D70067Medicare UPIN
TN0081448OtherBCBST