MEDICARE: JEFFERSON JONES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	80232	GA

General Provider Information

NPI Number	:	1336433119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFERSON JONES MD

Provider Business Mailing Address
First Line	:	5080 PEACHTREE BLVD
Second Line	:	SUITE 100
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2877
Country	:	US
Telephone Number	:	404-785-5437
Fax Number	:	404-785-8053

Provider Business Practice Location Address
First Line	:	5080 PEACHTREE BLVD
Second Line	:	SUITE 100
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2877
Country	:	US
Telephone Number	:	404-785-5437
Fax Number	:	404-785-8053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	06/06/2022

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