Provider Demographics
NPI:1750325056
Name:GRAHAM P JONES, MD, PA
Entity Type:Organization
Organization Name:GRAHAM P JONES, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-654-7117
Mailing Address - Street 1:152 HIMMELIEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9316
Mailing Address - Country:US
Mailing Address - Phone:609-654-7117
Mailing Address - Fax:609-654-8555
Practice Address - Street 1:152 HIMMELIEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9316
Practice Address - Country:US
Practice Address - Phone:609-654-7117
Practice Address - Fax:609-654-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA01999600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121882Medicare PIN