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General NPI Number Information
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NPI Number | 1427394402
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Entity Type | Organization
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Legal Business Name | KENNETH D. JONES M.D., P.C.
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 1430 HARPER ST STE C2
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City | AUGUSTA
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State | GA
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Zip | 30901-0621
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Country | US
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Telephone | 706-774-0404
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Fax | 706-774-1562
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Provider Business Mailing Address
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Address Line | 1430 HARPER ST STE C2
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City | AUGUSTA
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State | GA
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Zip | 30901-0621
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Country | US
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Telephone | 706-774-0404
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Fax | 706-774-1562
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Authorized Official
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Title or Position | PRESIDENT OF COMPANY
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Name | DR. KENNETH D. JONES
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Credential | M.D.
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Telephone | 706-774-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9182
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License Number State | GA
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