Healthcare Provider Details

I. General information

NPI: 1700820107
Provider Name (Legal Business Name): EDWARD CLAUDE JONES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S MAIN ST
DOBSON NC
27017-8593
US

IV. Provider business mailing address

701 S MAIN ST
DOBSON NC
27017-8593
US

V. Phone/Fax

Practice location:
  • Phone: 336-356-2600
  • Fax: 336-356-2601
Mailing address:
  • Phone: 336-356-2600
  • Fax: 336-356-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number32205
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2342249
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerGROUP MEDICARE
# 2
Identifier891034J
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: