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General NPI Number Information
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NPI Number | 1013001189
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Entity Type | Individual
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Provider Name | MATTHEW BRIAN JONES M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 30 CIRCLE J DR SUITE 1
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City | LAUREL
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State | MS
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Zip | 39440-1980
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Country | US
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Telephone | 601-425-0092
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Fax | 601-425-0473
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Provider Business Mailing Address
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Address Line | 30 CIRCLE J DR SUITE 1
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City | LAUREL
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State | MS
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Zip | 39440-1980
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Country | US
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Telephone | 601-425-0092
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Fax | 601-425-0473
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 17025
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17025
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17025
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License Number State | MS
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