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General NPI Number Information
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NPI Number | 1376768127
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Entity Type | Organization
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Legal Business Name | TRACEY JONES, M.D., P.C.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 1511 CARPENTER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2110
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Country | US
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Telephone | 215-923-2690
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Fax | 215-923-8940
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Provider Business Mailing Address
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Address Line | 1511 CARPENTER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2110
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Country | US
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Telephone | 215-923-2690
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Fax | 215-923-8940
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRACEY JONES
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Credential | M.D.
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Telephone | 215-923-2690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD064120L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD064120L
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License Number State | PA
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