MEDICARE: MACKENZIE TAYLOR JONES 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
1	2084P0800X	Psychiatry Physician	339070	NY
2	2084P0800X	Psychiatry Physician	A203078	CA
3	2084P0800X	Psychiatry Physician	97621	GA

General Provider Information

NPI Number	:	1831779792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE TAYLOR JONES MD

Provider Business Mailing Address
First Line	:	198 E 121ST ST FL 5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3523
Country	:	US
Telephone Number	:	212-803-2748
Fax Number	:	626-291-2665

Provider Business Practice Location Address
First Line	:	198 E 121ST ST FL 5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3523
Country	:	US
Telephone Number	:	212-803-2748
Fax Number	:	646-291-2665

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

Provider Enumeration Date	:	04/13/2021
Last Update Date	:	03/11/2026

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