Provider Demographics
NPI:1639402860
Name:JONES FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:JONES FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-859-0027
Mailing Address - Street 1:PO BOX 1740
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-1740
Mailing Address - Country:US
Mailing Address - Phone:601-859-0027
Mailing Address - Fax:601-859-0065
Practice Address - Street 1:134 E PEACE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-4520
Practice Address - Country:US
Practice Address - Phone:601-859-0027
Practice Address - Fax:601-859-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120026Medicaid
MS350000216Medicare PIN
MS60174Medicare UPIN