Provider Demographics
NPI:1760121461
Name:JONES, ROSEMERY R
Entity Type:Individual
Prefix:MRS
First Name:ROSEMERY
Middle Name:R
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 1:2638 GA HIGHWAY 195 S
Mailing Address - Street 2:
Mailing Address - City:LESLIE
Mailing Address - State:GA
Mailing Address - Zip Code:31764-2009
Mailing Address - Country:US
Mailing Address - Phone:229-938-7295
Mailing Address - Fax:
Practice Address - Street 1:2638 GA HIGHWAY 195 S
Practice Address - Street 2:
Practice Address - City:LESLIE
Practice Address - State:GA
Practice Address - Zip Code:31764-2009
Practice Address - Country:US
Practice Address - Phone:229-938-7295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor