Healthcare Provider Details

I. General information

NPI: 1760297592
Provider Name (Legal Business Name): TIMOTHY WILLIAM JONES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NORTHSIDE FORSYTH DR
CUMMING GA
30041-7659
US

IV. Provider business mailing address

555 COX RD
ROSWELL GA
30075-1011
US

V. Phone/Fax

Practice location:
  • Phone: 770-844-3907
  • Fax:
Mailing address:
  • Phone: 678-347-6781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberRPH031415
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberRPH031415
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: