Provider Demographics
NPI:1811391667
Name:JONES, ALONZO JR
Entity Type:Individual
Prefix:
First Name:ALONZO
Middle Name:
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 ROCKEFELLER AVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6430
Mailing Address - Country:US
Mailing Address - Phone:662-871-9143
Mailing Address - Fax:
Practice Address - Street 1:1003 ROCKEFELLER AVE
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6430
Practice Address - Country:US
Practice Address - Phone:662-871-9143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2279H0200X
MSRCP44692279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health