MEDICARE: DR. TIFFANNY LATRICE JONES M.D.

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	207V00000X	Obstetrics & Gynecology Physician	A124123	CA
2	207VE0102X	Reproductive Endocrinology Physician	59159	MN

General Provider Information

NPI Number	:	1073905998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIFFANNY LATRICE JONES M.D.

Provider Business Mailing Address
First Line	:	7515 GREENVILLE AVE STE 1030
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3866
Country	:	US
Telephone Number	:	214-224-0778
Fax Number	:

Provider Business Practice Location Address
First Line	:	7515 GREENVILLE AVE STE 1030
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3866
Country	:	US
Telephone Number	:	214-224-0778
Fax Number	:

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

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	06/17/2024

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