Healthcare Provider Details

I. General information

NPI: 1023845195
Provider Name (Legal Business Name): JOSEPH DOYLE JONES PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 RIDGEWOOD PL
JACKSON MS
39211-2018
US

IV. Provider business mailing address

PO BOX 13531
JACKSON MS
39236-3531
US

V. Phone/Fax

Practice location:
  • Phone: 601-957-3211
  • Fax: 601-957-9753
Mailing address:
  • Phone: 601-957-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number906912
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: