MEDICARE: THE JONES CLINIC, PC

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154347714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE JONES CLINIC, PC

Provider Business Mailing Address
First Line	:	7710 WOLF RIVER CIR
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-1734
Country	:	US
Telephone Number	:	901-685-5969
Fax Number	:	901-685-6424

Provider Business Practice Location Address
First Line	:	402 DOCTORS DR
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3109
Country	:	US
Telephone Number	:	662-538-5526
Fax Number	:	662-534-2882

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. JENNIFER R HATFIELD
Credential	:
Telephone Number	:	901-685-5969

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	08/21/2013

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