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NPI Code Detail

MEDICARE: JIMMIE L. JONES III MD

MEDICARE: JIMMIE L. JONES III 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1811880776
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIMMIE L. JONES III MD
Provider Business Mailing Address
First Line : 8027 CAMILLE AVE NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-5568
Country : US
Telephone Number : 505-321-4855
Fax Number :
Provider Business Practice Location Address
First Line : 1 SAINT MARY PL
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4307
Country : US
Telephone Number : 318-626-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2025
Last Update Date : 05/30/2025

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