Provider Demographics
NPI:1467558619
Name:JONES-NICE, PATRICIA G (MD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:G
Last Name:JONES-NICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71819
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30271-1819
Mailing Address - Country:US
Mailing Address - Phone:770-253-6001
Mailing Address - Fax:770-253-6402
Practice Address - Street 1:10 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1925
Practice Address - Country:US
Practice Address - Phone:770-253-6001
Practice Address - Fax:770-253-6402
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0521242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26BDKDPOtherPTAN
GA27-4711138OtherFED TAX ID - PRIVATE PRACTICE
GA052124OtherMEDICAL LIC - GEORGIA
GA052124OtherMEDICAL LIC - GEORGIA
GA26BDKDPOtherPTAN