Provider Demographics
NPI:1609930056
Name:JONES, KYLE ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ELLIOTT
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 99
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75461-0099
Mailing Address - Country:US
Mailing Address - Phone:903-785-4600
Mailing Address - Fax:903-782-9150
Practice Address - Street 1:3154 CLARKSVILLE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-8015
Practice Address - Country:US
Practice Address - Phone:903-785-4600
Practice Address - Fax:903-782-9150
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine