Provider Demographics
NPI:1215900709
Name:JONES, MARCUS
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 DAYTON PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4202
Mailing Address - Country:US
Mailing Address - Phone:423-842-2828
Mailing Address - Fax:423-842-1688
Practice Address - Street 1:8301 DAYTON PIKE STE B
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4202
Practice Address - Country:US
Practice Address - Phone:423-842-2828
Practice Address - Fax:423-842-1688
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD965111N00000X
TN521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD42612OtherSANFORD HEALTH
SD1744OtherAVERA HEALTH PLAN
IA2146571Medicaid
NE343569074Medicaid
SD4996028OtherBLUE CROSS/BLUE SHIELD
MN95M42JOOtherBLUE CROSS/BLUE SHIELD
SD7602500Medicaid
NE343569074Medicaid