Healthcare Provider Details

I. General information

NPI: 1063014702
Provider Name (Legal Business Name): MICHAEL LOUIS JONES II DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 CAINS HILL PL NW
ATLANTA GA
30305-1809
US

IV. Provider business mailing address

1869 BELMORE ST SE
SMYRNA GA
30080-1263
US

V. Phone/Fax

Practice location:
  • Phone: 404-548-8263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015047
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: