Provider Demographics
NPI:1912218231
Name:JONES, GEORGE PIERCE IV (PA)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:PIERCE
Last Name:JONES
Suffix:IV
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:120 HEALTH PARK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3701
Mailing Address - Country:US
Mailing Address - Phone:904-823-3401
Mailing Address - Fax:904-823-8649
Practice Address - Street 1:120 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3701
Practice Address - Country:US
Practice Address - Phone:904-823-3401
Practice Address - Fax:904-829-8649
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2012-01-24
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Provider Licenses
StateLicense IDTaxonomies
FL9105498363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant