Provider Demographics
NPI:1639177553
Name:JONES, LISTON STEPHEN JR (MD)
Entity Type:Individual
Prefix:
First Name:LISTON
Middle Name:STEPHEN
Last Name:JONES
Suffix:JR
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 160928
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36616-1928
Mailing Address - Country:US
Mailing Address - Phone:251-414-5900
Mailing Address - Fax:251-342-3842
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1753
Practice Address - Country:US
Practice Address - Phone:251-414-5900
Practice Address - Fax:251-281-1162
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00006675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0410322OtherUNITED HEALTHCARE
AL000018020Medicaid
AL051018020OtherBCBS
ALC73546Medicare UPIN
AL000018020Medicaid