Provider Demographics
NPI:1871676296
Name:JONES CENTER FOR WOMENS HEALTH
Entity Type:Organization
Organization Name:JONES CENTER FOR WOMENS HEALTH
Other - Org Name:MIND BODY SPIRIT WOMENS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:REESAL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-323-1626
Mailing Address - Street 1:PO BOX 41308
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-1308
Mailing Address - Country:US
Mailing Address - Phone:910-323-1626
Mailing Address - Fax:910-323-9056
Practice Address - Street 1:1261 OLIVER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4450
Practice Address - Country:US
Practice Address - Phone:910-323-1626
Practice Address - Fax:910-323-9056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137XNMedicaid
NC2340672Medicare PIN