Provider Demographics
NPI:1346465127
Name:JONES, GARY P (PAAA)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:PAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 PEACHTREE RD NW
Mailing Address - Street 2:STE 515
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-5219
Mailing Address - Country:US
Mailing Address - Phone:404-351-1745
Mailing Address - Fax:
Practice Address - Street 1:1640 AIRPORT RD NW
Practice Address - Street 2:STE 110
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7038
Practice Address - Country:US
Practice Address - Phone:678-202-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN003366367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant