Provider Demographics
NPI:1265433726
Name:JONES, JAMES G (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5070 PARKSIDE AVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4747
Mailing Address - Country:US
Mailing Address - Phone:267-507-3950
Mailing Address - Fax:215-477-8091
Practice Address - Street 1:5070 PARKSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:267-507-3950
Practice Address - Fax:215-477-8091
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054275L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001567333Medicaid
PA894162HFHMedicare ID - Type Unspecified
PA001567333Medicaid