Provider Demographics
NPI:1518062413
Name:JONES, JEFFREY EMERSON (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:EMERSON
Last Name:JONES
Suffix:
Gender:M
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 12156
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-2156
Mailing Address - Country:US
Mailing Address - Phone:757-867-6101
Mailing Address - Fax:757-867-6588
Practice Address - Street 1:1705 TARBORO ST SW
Practice Address - Street 2:WILSON MEDICAL CENTER
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3428
Practice Address - Country:US
Practice Address - Phone:252-399-8928
Practice Address - Fax:252-399-7477
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0098005822085R0202X
NC98005822085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00129616OtherRR MEDICARE
NC891137NMedicaid
NC1137NOtherBCBS
NC1137NOtherBCBS
NC891137NMedicaid