Provider Demographics
NPI:1013259589
Name:JONES CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:JONES CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-856-8850
Mailing Address - Street 1:121 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9198
Mailing Address - Country:US
Mailing Address - Phone:601-856-8850
Mailing Address - Fax:601-856-8957
Practice Address - Street 1:121 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9198
Practice Address - Country:US
Practice Address - Phone:601-856-8850
Practice Address - Fax:601-856-8957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS350000063Medicare PIN
MST78190Medicare UPIN