Provider Demographics
NPI:1669512364
Name:JONES, PAMELA D (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W SUMMIT HILL DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1025
Mailing Address - Country:US
Mailing Address - Phone:865-525-1099
Mailing Address - Fax:865-525-7494
Practice Address - Street 1:108 W SUMMIT HILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-1025
Practice Address - Country:US
Practice Address - Phone:865-525-1099
Practice Address - Fax:865-525-7494
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1947103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4056695OtherBLUE CROSS BLUE SHIELD
TN3981671Medicaid
TN4056695OtherBLUE CROSS BLUE SHIELD