Provider Demographics
NPI:1356673586
Name:JONES, TOMGA L
Entity Type:Individual
Prefix:
First Name:TOMGA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 REDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-7152
Mailing Address - Country:US
Mailing Address - Phone:205-994-6452
Mailing Address - Fax:205-994-6452
Practice Address - Street 1:192 REDSTONE WAY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-7152
Practice Address - Country:US
Practice Address - Phone:205-994-6452
Practice Address - Fax:205-994-6452
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL018950374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide