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General NPI Number Information
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NPI Number | 1902004013
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Entity Type | Individual
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Provider Name | DOROTHY JEANETTE JONES
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Gender | Female
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1004 COLLEGE ST
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City | PORT GIBSON
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State | MS
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Zip | 39150-2434
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Country | US
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Telephone | 601-437-3524
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Fax | 601-437-3570
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Provider Business Mailing Address
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Address Line | 1004 COLLEGE ST
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City | PORT GIBSON
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State | MS
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Zip | 39150-2434
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Country | US
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Telephone | 601-437-3524
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Fax | 601-437-3570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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