Provider Demographics
NPI:1821032392
Name:JONES, RACHEL ANTONIA
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANTONIA
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:PO BOX 3437
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39207-3437
Mailing Address - Country:US
Mailing Address - Phone:601-362-5321
Mailing Address - Fax:601-364-5159
Practice Address - Street 1:866 MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-4948
Practice Address - Country:US
Practice Address - Phone:601-372-1800
Practice Address - Fax:601-372-7043
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18055207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS080003778Medicare ID - Type UnspecifiedMEDICARE
MSI17249Medicare UPIN