Provider Demographics
NPI:1518988054
Name:JONES, DEWEY HOBSON III (MD)
Entity Type:Individual
Prefix:
First Name:DEWEY
Middle Name:HOBSON
Last Name:JONES
Suffix:III
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 1:3105 INDEPENDENCE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4111
Mailing Address - Country:US
Mailing Address - Phone:205-870-1498
Mailing Address - Fax:205-871-2851
Practice Address - Street 1:3105 INDEPENDENCE DR STE 105
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4111
Practice Address - Country:US
Practice Address - Phone:205-870-1498
Practice Address - Fax:205-871-2851
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005381174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051515045Medicaid
ALC75419Medicare UPIN
AL051515045Medicaid