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NPI Code Detail

MEDICARE: C MICHAEL JONES MDPC

MEDICARE: C MICHAEL JONES MDPC
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
13336C0002XClinic Pharmacy0000003590TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24434798OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1902961113
Entity Type Code : Organization
Provider Name (Legal Business Name) : C MICHAEL JONES MDPC
Provider Business Mailing Address
First Line : 7710 WOLF RIVER CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1734
Country : US
Telephone Number : 901-685-5969
Fax Number : 901-665-6424
Provider Business Practice Location Address
First Line : 7710 WOLF RIVER CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1734
Country : US
Telephone Number : 901-685-5969
Fax Number : 901-665-6424
Authorized Official
Title or Position : PHARM MGR
Name : ASHLEY MCCLURE
Credential : RPH
Telephone Number : 901-685-5969
Provider Enumeration Date : 12/27/2006
Last Update Date : 06/30/2010

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