Provider Demographics
NPI:1699038364
Name:TIMOTHY J JONES MD LLC
Entity Type:Organization
Organization Name:TIMOTHY J JONES MD LLC
Other - Org Name:TIMOTHY JOHN JONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-766-8220
Mailing Address - Street 1:2270 ASHLEY CROSSING DR.
Mailing Address - Street 2:SUITE 190
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5749
Mailing Address - Country:US
Mailing Address - Phone:843-766-8220
Mailing Address - Fax:843-766-8230
Practice Address - Street 1:2270 ASHLEY CROSSING DR.
Practice Address - Street 2:SUITE 190
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5749
Practice Address - Country:US
Practice Address - Phone:843-766-8220
Practice Address - Fax:843-766-8230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F96320Medicare UPIN