MEDICARE: MR. MICHAEL REESAL JONES MD

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	200401079	NC

General Provider Information

NPI Number	:	1275513020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL REESAL JONES MD

Provider Business Mailing Address
First Line	:	1261 OLIVER STREET
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4450
Country	:	US
Telephone Number	:	910-323-1626
Fax Number	:	910-323-9056

Provider Business Practice Location Address
First Line	:	1261 OLIVER ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4450
Country	:	US
Telephone Number	:	910-323-1626
Fax Number	:	910-323-9056

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	03/07/2025

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