Provider Demographics
NPI:1811257488
Name:JONES, FREDERIC GORDON SR (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:GORDON
Last Name:JONES
Suffix:SR
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 1:140 THE PINNACLE
Mailing Address - Street 2:
Mailing Address - City:SAPPHIRE
Mailing Address - State:NC
Mailing Address - Zip Code:28774-8513
Mailing Address - Country:US
Mailing Address - Phone:828-883-2668
Mailing Address - Fax:
Practice Address - Street 1:140 THE PINNACLE
Practice Address - Street 2:
Practice Address - City:SAPPHIRE
Practice Address - State:NC
Practice Address - Zip Code:28774-8513
Practice Address - Country:US
Practice Address - Phone:828-883-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401230207RC0000X
SC8773207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease