MEDICARE: JADE JONES

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1770031197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADE JONES

Provider Business Mailing Address
First Line	:	12305 HIGHWAY 57 STE B
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-9501
Country	:	US
Telephone Number	:	228-591-2032
Fax Number	:	228-591-2024

Provider Business Practice Location Address
First Line	:	12305 HIGHWAY 57 STE B
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-9501
Country	:	US
Telephone Number	:	228-238-0206
Fax Number	:

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

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	08/14/2025

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Directions to “ JADE JONES ” Practice Location

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