Provider Demographics
NPI: | 1740200047 |
---|---|
Name: | JONES, JAMES B (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | JAMES |
Middle Name: | B |
Last Name: | JONES |
Suffix: | |
Gender: | M |
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: | 5950 FAIRVIEW RD STE 330 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHARLOTTE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28210-2108 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 704-495-6334 |
Mailing Address - Fax: | 704-817-7219 |
Practice Address - Street 1: | 6060 PIEDMONT ROW DR S FL 10 |
Practice Address - Street 2: | |
Practice Address - City: | CHARLOTTE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28287 |
Practice Address - Country: | US |
Practice Address - Phone: | 704-489-3094 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-20 |
Last Update Date: | 2018-09-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 27927 | 207RP1001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 1740200047 | Medicaid | |
NC | 290014222 | Other | MEDICARE-RR |
NC | 47099 | Other | BCBSNC |
SC | N27927 | Medicaid | |
NC | 8947099 | Medicaid | |
NC | 47099 | Other | BCBSNC |
NC | 8947099 | Medicaid | |
NC | C84769 | Medicare UPIN |