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General NPI Number Information
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NPI Number | 1801222898
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Entity Type | Organization
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Legal Business Name | JONES FAMILY MEDICINE CLINIC, PLLC
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 235 S 14TH AVE
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City | LAUREL
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State | MS
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Zip | 39440-4227
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Country | US
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Telephone | 601-425-0092
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Fax |
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Provider Business Mailing Address
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Address Line | 235 S 14TH AVE
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City | LAUREL
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State | MS
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Zip | 39440-4227
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KAYE D JONES
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Credential |
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Telephone | 601-425-0092
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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 |
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License Number State |
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