Provider Demographics
NPI:1689601148
Name:JONES, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
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 1:1717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:800-822-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.124363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009963970Medicaid
AL051502526OtherBLUE CROSS
AL970025439OtherRAILROAD MEDICARE
AL000024861OtherBLUE CROSS
AL380000465OtherRAILROAD MEDICARE
AL000024861Medicaid
AL051502527OtherBLUE CROSS
AL051502527Medicaid
AL051523372OtherBLUE CROSS
AL009961705Medicaid
AL051502527Medicare ID - Type Unspecified
AL009961705Medicaid