Provider Demographics
NPI:1346467859
Name:JONES, JASON BRADFORD (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRADFORD
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 1:114 LAUREN LN
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27921-9648
Mailing Address - Country:US
Mailing Address - Phone:252-336-4807
Mailing Address - Fax:252-331-7799
Practice Address - Street 1:706 W EHRINGHAUS ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6933
Practice Address - Country:US
Practice Address - Phone:252-335-2225
Practice Address - Fax:252-331-7799
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085C0Medicaid
NC2454191Medicare ID - Type Unspecified
NC89085C0Medicaid