Provider Demographics
NPI:1376626192
Name:JONES, MICHAEL K (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
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 1:134 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-3735
Mailing Address - Country:US
Mailing Address - Phone:601-859-0027
Mailing Address - Fax:
Practice Address - Street 1:134 W CENTER ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-3735
Practice Address - Country:US
Practice Address - Phone:601-859-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120026Medicaid
MS3500002536Medicare ID - Type Unspecified