Provider Demographics
NPI:1912914953
Name:JONES, DENNIE VANCE JR (MD)
Entity Type:Individual
Prefix:
First Name:DENNIE
Middle Name:VANCE
Last Name:JONES
Suffix:JR
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 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 100278
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0278
Mailing Address - Country:US
Mailing Address - Phone:352-273-7832
Mailing Address - Fax:352-273-7849
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 100278
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0278
Practice Address - Country:US
Practice Address - Phone:352-273-7832
Practice Address - Fax:352-273-7849
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP782207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016745600Medicaid
FL016745600Medicaid