Provider Demographics
NPI:1669802963
Name:JONES, MELISSA S (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1655 LEBANON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5116
Mailing Address - Country:US
Mailing Address - Phone:770-682-2024
Mailing Address - Fax:770-682-2034
Practice Address - Street 1:1655 LEBANON RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5116
Practice Address - Country:US
Practice Address - Phone:770-682-2024
Practice Address - Fax:770-682-2034
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2014-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA007066363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical