Provider Demographics
NPI:1093005779
Name:JONES, JESSICA LYNN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE B321
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6799
Mailing Address - Country:US
Mailing Address - Phone:251-633-0793
Mailing Address - Fax:251-633-0736
Practice Address - Street 1:6701 AIRPORT BLVD STE B321
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6799
Practice Address - Country:US
Practice Address - Phone:251-633-0793
Practice Address - Fax:251-633-0736
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.34118207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4165548OtherAETNA
AL9108422OtherCIGNA
AL176940Medicaid
AL511-64896OtherBCBS
AL1093005779OtherTRICARE STANDARD NON
AL511-64896OtherBCBS