Provider Demographics
NPI:1841814803
Name:JONES, ANTHONY BRIAN (PA-C)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:BRIAN
Last Name:JONES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 KNOB CREEK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2396
Mailing Address - Country:US
Mailing Address - Phone:423-794-1074
Mailing Address - Fax:
Practice Address - Street 1:2428 KNOB CREEK RD STE 102
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2396
Practice Address - Country:US
Practice Address - Phone:865-584-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT15650AMedicaid