Provider Demographics
NPI:1962445353
Name:JONES, ANTHONY G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:G
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 MOUNT ZION RD
Mailing Address - Street 2:SUITE 389
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3313
Mailing Address - Country:US
Mailing Address - Phone:404-419-8182
Mailing Address - Fax:
Practice Address - Street 1:2045 MOUNT ZION RD
Practice Address - Street 2:SUITE 389
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-3313
Practice Address - Country:US
Practice Address - Phone:404-419-8182
Practice Address - Fax:888-418-3977
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE29302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145672001Medicaid
KY000000568892OtherANTHEM BCBS
KY7100048890Medicaid
KY0684420Medicare PIN
FLFY443Medicare UPIN
KY7100048890Medicaid
KY0050319Medicare PIN
AR145672001Medicaid
KYP00625931Medicare PIN
F71850Medicare UPIN
KY00151038Medicare PIN
KYP00625931Medicare PIN