Provider Demographics
NPI:1013495191
Name:JONES, KEITH DARNELL
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:DARNELL
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W ROOSEVELT AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2395
Mailing Address - Country:US
Mailing Address - Phone:229-434-4679
Mailing Address - Fax:229-434-4692
Practice Address - Street 1:235 W ROOSEVELT AVE STE 260
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2395
Practice Address - Country:US
Practice Address - Phone:229-434-4679
Practice Address - Fax:229-434-4692
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide