Provider Demographics
NPI:1598861692
Name:JONES, JAMES KEATING (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KEATING
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 DOCTORS DRIVE
Mailing Address - Street 2:STE 101
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240
Mailing Address - Country:US
Mailing Address - Phone:706-882-9524
Mailing Address - Fax:706-884-6845
Practice Address - Street 1:1555 DOCTORS DRIVE
Practice Address - Street 2:STE 101
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240
Practice Address - Country:US
Practice Address - Phone:706-882-9524
Practice Address - Fax:706-884-6845
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031035207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B53929Medicare UPIN