Provider Demographics
NPI:1841321411
Name:J GREGORY JONES MD PC
Entity type:Organization
Organization Name:J GREGORY JONES MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-741-1740
Mailing Address - Street 1:856 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6875
Mailing Address - Country:US
Mailing Address - Phone:478-741-1740
Mailing Address - Fax:
Practice Address - Street 1:856 1ST ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-6875
Practice Address - Country:US
Practice Address - Phone:478-741-1740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA29009207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD32880Medicare UPIN
GAP00422740Medicare Oscar/Certification
GA18BDGRCMedicare PIN