Provider Demographics
NPI:1932338027
Name:JONES, TRAVIS R (DPM)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:684 SIXES RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115
Mailing Address - Country:US
Mailing Address - Phone:770-517-6636
Mailing Address - Fax:770-517-6568
Practice Address - Street 1:900 TOWNE LAKE PKWY STE 320
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1604
Practice Address - Country:US
Practice Address - Phone:770-517-6636
Practice Address - Fax:770-517-6568
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006116213ES0103X
GAPOD001183213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery