MEDICARE: ANTHONY BRIAN JONES PA-C

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	363AM0700X	Medical Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841814803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY BRIAN JONES PA-C

Provider Business Mailing Address
First Line	:	2428 KNOB CREEK RD STE 102
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2396
Country	:	US
Telephone Number	:	423-794-1074
Fax Number	:

Provider Business Practice Location Address
First Line	:	2428 KNOB CREEK RD STE 102
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2396
Country	:	US
Telephone Number	:	865-584-0962
Fax Number	:

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

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	02/26/2021

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