MEDICARE: DR. JEFFREY B JONES PSYD

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	103TC0700X	Clinical Psychologist	3126	NC

General Provider Information

NPI Number	:	1841393436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY B JONES PSYD

Provider Business Mailing Address
First Line	:	FAYETTEVILLE VAMC
Second Line	:	2300 RAMSEY ST
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301
Country	:	US
Telephone Number	:	910-482-5077
Fax Number	:	910-482-5099

Provider Business Practice Location Address
First Line	:	FAYETTEVILLE VAMC
Second Line	:	2300 RAMSEY ST
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301
Country	:	US
Telephone Number	:	910-482-5077
Fax Number	:	910-482-5099

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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