MEDICARE: TRACEY JONES, M.D., P.C.

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	2084P0804X	Child & Adolescent Psychiatry Physician	MD064120L	PA
2	2084P0800X	Psychiatry Physician	MD064120L	PA

General Provider Information

NPI Number	:	1376768127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRACEY JONES, M.D., P.C.

Provider Business Mailing Address
First Line	:	1511 CARPENTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2110
Country	:	US
Telephone Number	:	215-923-2690
Fax Number	:	215-923-8940

Provider Business Practice Location Address
First Line	:	1511 CARPENTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2110
Country	:	US
Telephone Number	:	215-923-2690
Fax Number	:	215-923-8940

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TRACEY JONES
Credential	:	M.D.
Telephone Number	:	215-923-2690

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/07/2023

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