Provider Demographics
NPI:1720038532
Name:JONES, EVERETT RUSSELL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:RUSSELL
Last Name:JONES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:241 BOND TOWN RD
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5112
Mailing Address - Country:US
Mailing Address - Phone:423-579-2114
Mailing Address - Fax:
Practice Address - Street 1:241 BOND TOWN RD
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-5112
Practice Address - Country:US
Practice Address - Phone:423-579-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010514792084P0800X, 2084P0805X
NC2005-016842084P0800X, 2084P0805X
OH35-0481952084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFJ3472797OtherDEA