Provider Demographics
NPI:1316590201
Name:JONES, JAMES EUGENE
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EUGENE
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 1:312 BRANDIWOOD CT
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4219
Mailing Address - Country:US
Mailing Address - Phone:773-655-5514
Mailing Address - Fax:
Practice Address - Street 1:312 BRANDIWOOD CT
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-4219
Practice Address - Country:US
Practice Address - Phone:773-655-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator