MEDICARE: DAVID BLAKE JONES L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	127	GA

General Provider Information

NPI Number	:	1033662648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BLAKE JONES L.AC.

Provider Business Mailing Address
First Line	:	2222 ARBOR GATES DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5608
Country	:	US
Telephone Number	:	404-784-7789
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 W WIEUCA RD NE STE 209
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3252
Country	:	US
Telephone Number	:	404-784-7789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2016
Last Update Date	:	07/31/2016

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Directions to “ DAVID BLAKE JONES L.AC.” Practice Location

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