Provider Demographics
NPI:1487670287
Name:JONES, JOHN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2041 VALLEYGATE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3745
Mailing Address - Country:US
Mailing Address - Phone:910-323-5203
Mailing Address - Fax:910-323-3650
Practice Address - Street 1:2041 VALLEYGATE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3688
Practice Address - Country:US
Practice Address - Phone:910-323-5203
Practice Address - Fax:910-223-1621
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31843207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1784482-002OtherCIGNA
47134OtherBCBS
NC7947134Medicaid
47134OtherBCBS
NCC39872Medicare UPIN