Provider Demographics
NPI:1710952965
Name:JONES, SHAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5835 CAMPBELLTON RD
Mailing Address - Street 2:STE 204
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331
Mailing Address - Country:US
Mailing Address - Phone:404-349-3601
Mailing Address - Fax:404-393-0691
Practice Address - Street 1:5835 CAMPBELLTON RD
Practice Address - Street 2:STE 204
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331
Practice Address - Country:US
Practice Address - Phone:404-349-3601
Practice Address - Fax:404-393-0691
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02856Medicare UPIN