Provider Demographics
NPI:1326244419
Name:JONES, MELVIN DENNIS (PT)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:DENNIS
Last Name:JONES
Suffix:
Gender:M
Credentials:PT
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-1265
Mailing Address - Fax:704-316-1266
Practice Address - Street 1:14330 OAKHILL PARK LN
Practice Address - Street 2:SUITE 200-B
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3314
Practice Address - Country:US
Practice Address - Phone:704-316-1265
Practice Address - Fax:704-316-1266
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NCP11155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2506283Medicare PIN