Provider Demographics
NPI:1629790498
Name:JONES, ALICE BARTON
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:BARTON
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 FOUNTAINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BEULAVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28518-7567
Mailing Address - Country:US
Mailing Address - Phone:910-330-4562
Mailing Address - Fax:910-375-3332
Practice Address - Street 1:1369 FOUNTAINTOWN RD
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-7567
Practice Address - Country:US
Practice Address - Phone:910-330-4562
Practice Address - Fax:910-375-3332
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3603151343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)