Provider Demographics
NPI:1982288890
Name:JONES, MERCEDES (PA-C)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MJ
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21400 TAMMIE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:AL
Mailing Address - Zip Code:35111-1147
Mailing Address - Country:US
Mailing Address - Phone:205-908-9235
Mailing Address - Fax:
Practice Address - Street 1:1330 HIGHWAY 231 S
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3058
Practice Address - Country:US
Practice Address - Phone:334-670-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1766363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant