Provider Demographics
NPI:1790857373
Name:JONES, MOSES MARCUS (MD)
Entity Type:Individual
Prefix:DR
First Name:MOSES
Middle Name:MARCUS
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 1:525 EAST BROAD STREET
Mailing Address - Street 2:EUFAULA
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1736
Mailing Address - Country:US
Mailing Address - Phone:334-687-4827
Mailing Address - Fax:334-687-4828
Practice Address - Street 1:525 EAST BROAD STREET
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1736
Practice Address - Country:US
Practice Address - Phone:334-687-4827
Practice Address - Fax:334-687-4828
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9022207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72448Medicare UPIN