Healthcare Provider Details

I. General information

NPI: 1285100594
Provider Name (Legal Business Name): JMJ ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15155 HIGHWAY 43
RUSSELLVILLE AL
35653-1975
US

IV. Provider business mailing address

544 COUNTY ROAD 176
MOULTON AL
35650-5767
US

V. Phone/Fax

Practice location:
  • Phone: 256-332-1611
  • Fax:
Mailing address:
  • Phone: 615-428-1594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES PHILIP JONES
Title or Position: PRESIDENT
Credential: CRNA
Phone: 615-428-1594