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General NPI Number Information
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NPI Number | 1346446705
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Entity Type | Organization
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Legal Business Name | JONES FAMILY MEDICAL CLINIC, PLLC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 1200 N GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38804-1206
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Country | US
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Telephone | 662-840-0990
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Fax | 662-840-0182
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Provider Business Mailing Address
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Address Line | 1200 N GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38804-1206
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Country | US
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Telephone | 662-840-0990
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Fax | 662-840-0182
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATHY M ALLRED
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Credential | RHIT
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Telephone | 662-840-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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