Provider Demographics
NPI:1770680571
Name:JONES, DON WITHERALL (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:WITHERALL
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 PLANTERS TRL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-3981
Mailing Address - Country:US
Mailing Address - Phone:706-467-9645
Mailing Address - Fax:
Practice Address - Street 1:1250 PLANTERS TRL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-3981
Practice Address - Country:US
Practice Address - Phone:706-467-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000011634Medicare ID - Type UnspecifiedMEDICARE #
ALC72444Medicare UPIN