Provider Demographics
NPI:1588834295
Name:JONES, ERIC SCOTT
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
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 1:612 EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-3452
Mailing Address - Country:US
Mailing Address - Phone:865-293-2572
Mailing Address - Fax:
Practice Address - Street 1:1024 MIDDLE CREEK RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6921
Practice Address - Country:US
Practice Address - Phone:865-453-9022
Practice Address - Fax:865-453-9177
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT00000007105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist