Provider Demographics
NPI:1487404430
Name:JONES, MICHEAL KEVIN
Entity type:Individual
Prefix:MR
First Name:MICHEAL
Middle Name:KEVIN
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 1:1015 RED ROCK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-0420
Mailing Address - Country:US
Mailing Address - Phone:919-599-2493
Mailing Address - Fax:
Practice Address - Street 1:1015 RED ROCK DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-0420
Practice Address - Country:US
Practice Address - Phone:919-599-2493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician