Provider Demographics
NPI:1154347714
Name:THE JONES CLINIC, PC
Entity type:Organization
Organization Name:THE JONES CLINIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-5969
Mailing Address - Street 1:7710 WOLF RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1734
Mailing Address - Country:US
Mailing Address - Phone:901-685-5969
Mailing Address - Fax:901-685-6424
Practice Address - Street 1:402 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3109
Practice Address - Country:US
Practice Address - Phone:662-538-5526
Practice Address - Fax:662-534-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015323Medicaid
MSC02517Medicare PIN
MS09015323Medicaid
TN122796001Medicare PIN
TN3714580Medicare PIN