Provider Demographics
NPI:1801222898
Name:JONES FAMILY MEDICINE CLINIC, PLLC
Entity Type:Organization
Organization Name:JONES FAMILY MEDICINE CLINIC, PLLC
Other - Org Name:JFMC THE Q, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-425-0092
Mailing Address - Street 1:235 S 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 S 14TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4227
Practice Address - Country:US
Practice Address - Phone:601-425-0092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONES FAMILY MEDICINE CLINIC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-23
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care