Provider Demographics
NPI:1831639764
Name:JONES, MATTHEW CHRISTIAN (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHRISTIAN
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HIGHWAY 70 E STE I
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2075
Mailing Address - Country:US
Mailing Address - Phone:615-441-4503
Mailing Address - Fax:615-441-4575
Practice Address - Street 1:113 HIGHWAY 70 E STE I
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2075
Practice Address - Country:US
Practice Address - Phone:615-441-4503
Practice Address - Fax:615-441-4575
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-25
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL52010208600000X
MI390200000X
TN5438208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program