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General NPI Number Information
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NPI Number | 1821241217
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Entity Type | Organization
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Legal Business Name | STACY D JONES MEDICAL GROUP LLC
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | 3401 NORTH BLVD 130
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City | BATON ROUGE
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State | LA
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Zip | 70806-3743
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Country | US
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Telephone | 225-381-2727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64680
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City | BATON ROUGE
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State | LA
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Zip | 70896-4680
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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 | OWNER
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Name | STACY D JONES
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Credential | MD
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Telephone | 225-381-2727
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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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