Provider Demographics
NPI:1265539746
Name:JONES, DEBRA ROBINSON (DC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ROBINSON
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 MILL CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-8412
Mailing Address - Country:US
Mailing Address - Phone:843-207-8360
Mailing Address - Fax:
Practice Address - Street 1:4209 MILL CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-8412
Practice Address - Country:US
Practice Address - Phone:843-207-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL62400Medicare UPIN
SC8148Medicare ID - Type Unspecified