Provider Demographics
NPI:1316351927
Name:JONES, SHAWN CHRISTOPHER TRACEY (MA MHS)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:CHRISTOPHER TRACEY
Last Name:JONES
Suffix:
Gender:M
Credentials:MA MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 NORTHCREEK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3370
Mailing Address - Country:US
Mailing Address - Phone:210-473-5738
Mailing Address - Fax:
Practice Address - Street 1:1004 DRESSER CT
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7325
Practice Address - Country:US
Practice Address - Phone:919-876-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program