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NPI Code Detail

MEDICARE: DR. THEODORE W JONES PHD

MEDICARE:  DR. THEODORE W JONES  PHD
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
1103TC0700XClinical PsychologistP0000873TN

Other Identifiers

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

General Provider Information

NPI Number : 1457382780
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THEODORE W JONES PHD
Provider Business Mailing Address
First Line : 6231 HIGHLAND PLACE WAY
Second Line : STE 101
City : KNOXVILLE
State : TN
Zip : 37919-4083
Country : US
Telephone Number : 865-264-2400
Fax Number : 865-588-6406
Provider Business Practice Location Address
First Line : 1128 E WEISGARBER RD
Second Line : SUITE 100
City : KNOXVILLE
State : TN
Zip : 37909-2674
Country : US
Telephone Number : 865-579-0552
Fax Number : 865-579-1154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 06/27/2019

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Directions to “ DR. THEODORE W JONES PHD” Practice Location

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