=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487016499
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TYLER SNOW JONES M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2016
-----------------------------------------------------
Last Update Date | 08/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 MEMORIAL HOSPITAL DR STE 1D
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36608-1194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-342-0030
-----------------------------------------------------
Fax | 205-449-3395
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 MEMORIAL HOSPITAL DR STE 1D
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36608-1180
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-342-0030
-----------------------------------------------------
Fax | 205-449-3395
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | 42626
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------