Provider Demographics
NPI:1518582030
Name:JONES, CODY ALEXANDER
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:ALEXANDER
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 THORNTON ST
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2633
Mailing Address - Country:US
Mailing Address - Phone:910-584-0032
Mailing Address - Fax:
Practice Address - Street 1:1ST MARINE RAIDER BATTALION MEDICAL
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92055-5341
Practice Address - Country:US
Practice Address - Phone:910-584-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman