Provider Demographics
NPI:1326177650
Name:JONES, JEFFERY PATRICK (DC,)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:PATRICK
Last Name:JONES
Suffix:
Gender:M
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9198
Mailing Address - Country:US
Mailing Address - Phone:601-856-8850
Mailing Address - Fax:601-856-8957
Practice Address - Street 1:121 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9198
Practice Address - Country:US
Practice Address - Phone:601-856-8850
Practice Address - Fax:601-856-8957
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS350019405OtherPALMETTORAILROAD MEDICARE
MS350019405OtherPALMETTORAILROAD MEDICARE
MS350019405OtherPALMETTORAILROAD MEDICARE
MS640699842OtherTIN#