Healthcare Provider Details
I. General information
NPI: 1053498808
Provider Name (Legal Business Name): THE JONES CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506 AZALEA DR
OXFORD MS
38655-8100
US
IV. Provider business mailing address
PO BOX 1000 DEPT 552
MEMPHIS TN
38148-0001
US
V. Phone/Fax
- Phone: 662-513-4401
- Fax: 662-513-4414
- Phone: 901-685-5969
- Fax: 901-685-6424
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CLYDE
MICHEAL
JONES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 901-685-5969