Provider Demographics
NPI:1417967688
Name:JONES, CHRISTOPHER RIDDELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RIDDELL
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:817 PRINCETON AVE SW
Mailing Address - Street 2:SUITE 300 - POB II
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1333
Mailing Address - Country:US
Mailing Address - Phone:205-780-8980
Mailing Address - Fax:205-785-1554
Practice Address - Street 1:5295 PRESERVE PKWY
Practice Address - Street 2:STE 270
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4705
Practice Address - Country:US
Practice Address - Phone:205-780-8980
Practice Address - Fax:205-785-1554
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10315208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051503507Medicaid
AL009973990Medicaid
AL051503507Medicare ID - Type UnspecifiedPRINCETON & SHELBY (SAME)
AL009973990Medicaid