Provider Demographics
NPI:1255385126
Name:JONES, LINDA (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E SHOTWELL ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4256
Mailing Address - Country:US
Mailing Address - Phone:229-246-3500
Mailing Address - Fax:
Practice Address - Street 1:1500 E. SHOTWELL ST.
Practice Address - Street 2:MEMORIAL HOSPITAL & MANOR
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819
Practice Address - Country:US
Practice Address - Phone:229-243-6200
Practice Address - Fax:229-243-3317
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030111207P00000X
TNMD36814207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA030111OtherMEDICAL LICENSE
TN4064531OtherBLUE CROSS
GA00359983DMedicaid
TN3894377Medicare ID - Type Unspecified
GA00359983DMedicaid