Provider Demographics
NPI:1063419281
Name:JONES, WILLIAM BIRD (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BIRD
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:660-A LANIER PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2075
Mailing Address - Country:US
Mailing Address - Phone:770-535-0000
Mailing Address - Fax:770-532-3911
Practice Address - Street 1:660-A LANIER PARK DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2075
Practice Address - Country:US
Practice Address - Phone:770-535-0000
Practice Address - Fax:770-532-3911
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01021167208800000X
GA21167208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00190638AMedicaid
GA260960438COtherMEDICARE
GAD70479Medicare UPIN