Provider Demographics
NPI:1467539213
Name:THE JONES CLINIC, PC
Entity Type:Organization
Organization Name:THE JONES CLINIC, PC
Other - Org Name:C. MICHAEL JONES, MD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-685-5969
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 552
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-685-5969
Mailing Address - Fax:901-685-6424
Practice Address - Street 1:200 STATE HIGHWAY 30 W
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3112
Practice Address - Country:US
Practice Address - Phone:662-538-2525
Practice Address - Fax:662-534-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02517Medicare ID - Type UnspecifiedGROUP NUMBER