Provider Demographics
NPI:1407014103
Name:JONES, ELLIOT HUNTER (BS)
Entity Type:Individual
Prefix:MR
First Name:ELLIOT
Middle Name:HUNTER
Last Name:JONES
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WEATHERFORD SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2202
Mailing Address - Country:US
Mailing Address - Phone:731-660-6721
Mailing Address - Fax:731-661-9852
Practice Address - Street 1:24 WEATHERFORD SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2202
Practice Address - Country:US
Practice Address - Phone:731-660-6721
Practice Address - Fax:731-661-9852
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker