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NPI Code Detail

MEDICARE: DR. SHIRLEY EILEEN JONES M.D.

MEDICARE: DR. SHIRLEY EILEEN 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
1207Q00000XFamily Medicine Physician049042GA
2207Q00000XFamily Medicine Physician22666AL
3207Q00000XFamily Medicine PhysicianME113465FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
214KY6OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740273085
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRLEY EILEEN JONES M.D.
Provider Business Mailing Address
First Line : 6856 103RD ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-6877
Country : US
Telephone Number : 904-777-0616
Fax Number : 904-111-0688
Provider Business Practice Location Address
First Line : 6856 103RD ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-6877
Country : US
Telephone Number : 904-777-0616
Fax Number : 904-111-0688
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 06/13/2014

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